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

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The big difference with the 1918 pandemic was that it was initially transmitted throughout the world by the world's militaries.

Yes. And the World today has human interaction on a whole different level than 1918.
People traveling freely today both internationally and domestically puts transmission chances on a different level.
 
Yes. And the World today has human interaction on a whole different level than 1918.
People traveling freely today both internationally and domestically puts transmission chances on a different level.
Right, but we have instant communication capabilities that they did not have back then. For months people were shipping out all over the world with no idea that they were transmitting a deadly illness. Back then it was the trains carrying them (and ocean going ships) rather than the air travel we have today.
 
All good - it's a very minor point - big picture 1918 was horrific and this virus has that potential if no actions are taken and if the real fatality rate is ~2%, which is what was estimated to be the rate for 1918, not the 0.5-1.0% I've been talking about for days. Fauci and many others think it's in the 0.5-1.0% range (otherwise I wouldn't be saying it), which is much less than the 2-5% we're seeing in many countries (or the 6.6% in Italy), since we don't know the denominator of total infections yet - except we're probably close to that in SK which is now at a 0.8% morality rate, with, by far, the greatest testing rate per capita. Even at a "true" mortality rate of 0.8%, that's about 8X more than the regular flu. We can also hope that it's even lower - Germany's is at 0.2%, by far the lowest of any country with over 2000 confirmed cases - and Norway/Sweden are at 0.1%, although still less than 1000 cases.

SK's CFR has been creeping up toward 1% and should be expected to continue to rise. They still have many unresolved cases and since resolution to "cure" or death often takes weeks, well...the only question is how high does that rate go.

Good thing for them is that the rate of new cases has dropped a lot, at least for now.

I have't seen any breakdowns of SK cases/CFR by age, has anyone seen that kind of info anywhere?
 
SK's CFR has been creeping up toward 1% and should be expected to continue to rise. They still have many unresolved cases and since resolution to "cure" or death often takes weeks, well...the only question is how high does that rate go.

Good thing for them is that the rate of new cases has dropped a lot, at least for now.

I have't seen any breakdowns of SK cases/CFR by age, has anyone seen that kind of info anywhere?
Yep, noticed that as it's up to 0.8%, from 0.6%, but the new case rate is significantly down (outside of one new cluster). It's why I've been thinking all along that the eventual "true" mortality rate will be 0.5-1.0%. Here is the link I use for country data, but haven't seen age-specific data - wish I could cut/paste their graphics, but haven't figured out how to do that.

https://www.worldometers.info/coronavirus/country/south-korea/

The only age data I've seen is data I think we've all seen before from China/WHO, which I copied below.

AGE vs.DEATH RATE all cases

80+ years old 14.8%

70-79 years old, 8.0%

60-69 years old, 3.6%

50-59 years old, 1.3%

40-49 years old, 0.4%

30-39 years old, 0.2%

20-29 years old, 0.2%

10-19 years old, 0.2%

0-9 years old, no fatalities

https://www.worldometers.info/coronavirus/coronavirus-age-sex-demographics/
 
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Hadn't seen that one. There's certainly likely 10X more infected people walking around than confirmed infections, just because of math, but 100K in Ohio? That's just nutty - someone was using Brian Williams math on that one, lol.

Yeah was weird because we would likely see many rushing emergency rooms by now even with a lag in symptoms
 
Numbers what do you make off the fact that only 4% or so of those being tested in So Korea are testing postive..that seems low
 
Numbers what do you make off the fact that only 4% or so of those being tested in So Korea are testing postive..that seems low
It's low because they've tested so many more people, per capita than anyone else, so it's not that surprising they're finding mostly negative test results. I hope it means they're on their way to containing it, as reflected by the decrease in new cases over the past 5-6 days. Other countries with far less testing, like the US, have over 20% positive test results.
 
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It's low because they've tested so many more people, per capita than anyone else, so it's not that surprising they're finding mostly negative test results. I hope it means they're on their way to containing it, as reflected by the decrease in new cases over the past 5-6 days. Other countries with far less testing, like the US, have over 20% positive test results.
The more you test the more you find the more you isolate so it doesn't spread further. But I did see after a point it doesn't matter any more cause it's out there so widely testing serves no purpose. Don't know we're at the point yet though.

Also saw on CNN a small study/observation of like 12 patients some with even a milder infection of coronavirus can have some longer term lung damage like 20-30% reduction in lung function. Still too early and not a large enough sample to say what the long term effects are though.

From a business insider article I found:

People who recover after being infected with the novel coronavirus can still be left with substantially weakened lung capacity, with some left gasping for air when walking quickly, doctors in Hong Kong have found.

The Hong Kong Hospital Authority made the findings after studying the first wave of patients who were discharged from the hospital and had fully recovered from COVID-19.

Out of 12 people in the group, two to three saw changes in their lung capacity.

"They gasp if they walk a bit more quickly," Owen Tsang Tak-yin, the medical director of the authority's Infectious Disease Centre, told a press conference Thursday, according to the South China Morning Post.

"Some patients might have around a drop of 20 to 30% in lung function" after full recovery, he said.

Tsang added, however, that patients can do cardiovascular exercises, like swimming, the improve their lung capacity over time.

While it's too early to establish long-term effects of the disease, scans of nine patients' lungs also "found patterns similar to frosted glass in all of them, suggesting there was organ damage," Tsang said, according to the Post.

Current coronavirus patients' CT scans show "ground glass," a phenomenon in which fluid builds up in lungs and presents itself as white patches, as Business Insider's Aria Bendix has reported. The scans below, taken from one coronavirus patient at different points in time, show that the person's "ground glass" became more pronounced as their illness progressed.

https://www.businessinsider.com/cor...function-gasping-air-hong-kong-doctors-2020-3
 
The more you test the more you find the more you isolate so it doesn't spread further. But I did see after a point it doesn't matter any more cause it's out there so widely testing serves no purpose. Don't know we're at the point yet though.

Also saw on CNN a small study/observation of like 12 patients some with even a milder infection of coronavirus can have some longer term lung damage like 20-30% reduction in lung function. Still too early and not a large enough sample to say what the long term effects are though.

From a business insider article I found:

People who recover after being infected with the novel coronavirus can still be left with substantially weakened lung capacity, with some left gasping for air when walking quickly, doctors in Hong Kong have found.

The Hong Kong Hospital Authority made the findings after studying the first wave of patients who were discharged from the hospital and had fully recovered from COVID-19.

Out of 12 people in the group, two to three saw changes in their lung capacity.

"They gasp if they walk a bit more quickly," Owen Tsang Tak-yin, the medical director of the authority's Infectious Disease Centre, told a press conference Thursday, according to the South China Morning Post.

"Some patients might have around a drop of 20 to 30% in lung function" after full recovery, he said.

Tsang added, however, that patients can do cardiovascular exercises, like swimming, the improve their lung capacity over time.

While it's too early to establish long-term effects of the disease, scans of nine patients' lungs also "found patterns similar to frosted glass in all of them, suggesting there was organ damage," Tsang said, according to the Post.

Current coronavirus patients' CT scans show "ground glass," a phenomenon in which fluid builds up in lungs and presents itself as white patches, as Business Insider's Aria Bendix has reported. The scans below, taken from one coronavirus patient at different points in time, show that the person's "ground glass" became more pronounced as their illness progressed.

https://www.businessinsider.com/cor...function-gasping-air-hong-kong-doctors-2020-3
That's one of the things that I've been concerned about. It's great to say that "if you're under 60 you're probably going to survive", but even if you're under 60 you could still wind up with a fairly serious pneumonia that requires ICU care. You might (probably will) survive but you might have long term consequences. That's not uncommon with any type of pneumonia. And that kind of damage could then make it more likely that you'll be more severely impacted by the flu or other viruses/bacteria in the future.
 
SIAP, but how's this for stupidity from the UK? Just let everyone get the virus to get "herd immunity" (which really applies to vaccines). They're nuts, although I've seen a few folks around here proposing we should do that, so we don't have the economic dislocations of shutting things down. Reminds me of Airplane's parody of the old 60 Minutes Point-Counterpoint arguments...

https://www.youtube.com/watch?v=Pn0WdJx-Wkw

https://www.theguardian.com/world/2...oOTJKb13j6Fa2Ry1hLbbD7zbdAmTZVPlfi6CA-CHSUB0A
 
SIAP, but how's this for stupidity from the UK? Just let everyone get the virus to get "herd immunity" (which really applies to vaccines). They're nuts, although I've seen a few folks around here proposing we should do that, so we don't have the economic dislocations of shutting things down. Reminds me of Airplane's parody of the old 60 Minutes Point-Counterpoint arguments...

https://www.youtube.com/watch?v=Pn0WdJx-Wkw

https://www.theguardian.com/world/2...oOTJKb13j6Fa2Ry1hLbbD7zbdAmTZVPlfi6CA-CHSUB0A
I think I've said before - it sounds great unless you wind up needing hospital care when the system is overwhelmed because everyone else has the virus. Go home and good luck
 
One positive case - now discharged home to isolation.
Major radiology group refusing to do ct scans on sick at risk outpatients.
And a whole law office who is freaking out over their exposure to him. One of my office nurses may have bailed. Lots of mental health issues compounding mess. 10 kits left and LabCorp claims theirs should have reached me days ago.
Must be lost in mail.
 
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One positive case - now discharged home to isolation.
Major radiology group refusing to do ct scans on sick at risk outpatients.
And a whole law office who is freaking out over their exposure to him. One of my office nurses may have bailed. Lots of mental health issues compounding mess. 10 kits left and LabCorp claims theirs should have reached me days ago.
Must be lost in mail.
Thanks for the update - keep 'em coming. Can you share where you are or at least what hospital area you work in? How many test kits do you think you will need per day or week vs. what you have and which is supposedly coming (even a guess)?

A doc on CNN just said we have 2.3 beds per 100K population, same as Italy, while South Korea has 15 beds per 100K population and says we're going to likely run out very quickly. So if social distancing doesn't start working soon, hospitals will be overwhelmed, especially in this area.
 
Thanks for the update - keep 'em coming. Can you share where you are or at least what hospital area you work in? How many test kits do you think you will need per day or week vs. what you have and which is supposedly coming (even a guess)?

A doc on CNN just said we have 2.3 beds per 100K population, same as Italy, while South Korea has 15 beds per 100K population and says we're going to likely run out very quickly. So if social distancing doesn't start working soon, hospitals will be overwhelmed, especially in this area.


My practice is in Central Jersey.
Would have liked to have started testing patients at the beginning of the week but have to conserve what I got kit-wise.
Things are much worse than I ever expected with our major commercial labs.
I would have liked to see them enclose 2 Swab's in a packet. They also were issuing contradictory refrigeration versus freezing instructions. Would expect my partner and I to use 10 to 20 packets/day beginning next week. We have canceled all follow up/ routine appointments for the next few weeks so as to limit exposure on all fronts. Now I understand the expression the fog of war. A few miles north of us there is an ER doctor who got a large viral load who's not doing very well.
 
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Thanks for the update - keep 'em coming. Can you share where you are or at least what hospital area you work in? How many test kits do you think you will need per day or week vs. what you have and which is supposedly coming (even a guess)?

A doc on CNN just said we have 2.3 beds per 100K population, same as Italy, while South Korea has 15 beds per 100K population and says we're going to likely run out very quickly. So if social distancing doesn't start working soon, hospitals will be overwhelmed, especially in this area.

According to a paper published in the Intensive Care Medicine journal utilizing 2012 data, Italy had 12.5 ICU beds per 100,000 of its population that year while Germany had 29.2 ICU beds per 100,000 inhabitants. A different paper published by the National Center for Biotechnology Information in 2015 states that capacity in the United States is even higher at 34.2 ICU beds per 100,000 people.

Also, the median age in the U.S. is ten years younger than Italy. That is before you account for the fact that the place of the outbreak in Italy likely has an even higher median age.

Even if the U.S. reacts the same way Italy did, conditions here won't be as bad as quick just due to other circumstances.
 
It's low because they've tested so many more people, per capita than anyone else, so it's not that surprising they're finding mostly negative test results. I hope it means they're on their way to containing it, as reflected by the decrease in new cases over the past 5-6 days. Other countries with far less testing, like the US, have over 20% positive test results.

It seems low based on how easily it has been said to spread. The Ohio number of 117k doesn't seem unreasonable if it does indeed spread easily and has been circulating unchecked for more than a month.
 
It seems low based on how easily it has been said to spread. The Ohio number of 117k doesn't seem unreasonable if it does indeed spread easily and has been circulating unchecked for more than a month.
Sorry, there's no way that number is right and the person even walked it back a bit (see bac's link). In fact a much more reasonable guesstimate is the 10X number I've seen in many locations (10X the number of + cases are likely infected, but not known) and posted about earlier. In that link above, the following was also said, which makes sense - basically, we'd have far more serious cases and deaths in Ohio if there were 100K infected. Ohio has 13 confirmed cases, so 100-200 actual is a much better guess.

Dr. Trevor Bedford, a physician at the vaccine and infectious disease division of Fred Hutch, noted that when there were around 100,000 infections in Wuhan, China, the epicenter of the outbreak, there were 1,000 severe cases in the city, and 300 deaths.

“Thus, given the severity of this disease I don’t see how it’s possible to reach 100k infections and not notice it in deaths and hospitalizations,” Bedford wrote on Twitter, adding that he “very respectfully disagree[d]” with Acton’s estimate.
 
It seems low based on how easily it has been said to spread. The Ohio number of 117k doesn't seem unreasonable if it does indeed spread easily and has been circulating unchecked for more than a month.

If its been circulating for a month you have more people in emergency rooms...100k is absurd...if its true than its not as potent as thought
 
Sorry, there's no way that number is right and the person even walked it back a bit (see bac's link). In fact a much more reasonable guesstimate is the 10X number I've seen in many locations (10X the number of + cases are likely infected, but not known) and posted about earlier. In that link above, the following was also said, which makes sense - basically, we'd have far more serious cases and deaths in Ohio if there were 100K infected. Ohio has 13 confirmed cases, so 100-200 actual is a much better guess.

Dr. Trevor Bedford, a physician at the vaccine and infectious disease division of Fred Hutch, noted that when there were around 100,000 infections in Wuhan, China, the epicenter of the outbreak, there were 1,000 severe cases in the city, and 300 deaths.

“Thus, given the severity of this disease I don’t see how it’s possible to reach 100k infections and not notice it in deaths and hospitalizations,” Bedford wrote on Twitter, adding that he “very respectfully disagree[d]” with Acton’s estimate.

Numbers....if you had to predict this like a snow storm. What is best case/worst case ? Mostly likely scenarios ?
 
Numbers....if you had to predict this like a snow storm. What is best case/worst case ? Mostly likely scenarios ?
That snippet I copied above from a WaPo article with Tom Frieden ex-CDC head gave a bunch of scenarios from best to worst and it’s a wide range....also over two to three year timeframe.

EDIT: Here it is.

An excerpt from a WaPo article...very wide range of outcomes.

Another forecast, developed by former CDC director Tom Frieden at the nonprofit organization Resolve to Save Lives, found that deaths in the United States could range widely, depending on what percentage of the population becomes infected and how lethal the disease proves to be. Frieden, who oversaw the U.S. response to the 2009 H1N1 influenza pandemic, the 2014 Ebola epidemic and the 2016 Zika epidemic, says that in a worst-case scenario, but one that is not implausible, half the U.S. population would become infected and more than 1 million people would die.

His team put together a simple table that looks at various scenarios using case fatality ratios ranging from .1, similar to seasonal flu, to .5, a moderately severe pandemic, and 1.0, a severe one. The infection rate ranged from 0.1 percent of the population to 50 percent. That put the range of deaths at 327 (best case) to 1,635,000 (worst case). The deaths would not necessarily happen over a month or a year, but could occur over two or three years, he said.
 
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According to a paper published in the Intensive Care Medicine journal utilizing 2012 data, Italy had 12.5 ICU beds per 100,000 of its population that year while Germany had 29.2 ICU beds per 100,000 inhabitants. A different paper published by the National Center for Biotechnology Information in 2015 states that capacity in the United States is even higher at 34.2 ICU beds per 100,000 people.

Also, the median age in the U.S. is ten years younger than Italy. That is before you account for the fact that the place of the outbreak in Italy likely has an even higher median age.

Even if the U.S. reacts the same way Italy did, conditions here won't be as bad as quick just due to other circumstances.
According to the OECD, the US is near the bottom in hospital beds per 1000 people with 2.7 per 1000, a bit below Italy (~3) and well below Germany (8) and South Korea (12). You are correct about Italy's population being older, but areas like the DC-Boston corridor are 2-3X more densely populated than Italy, so those might cancel out. I think places like NYC could end up being worse than what we're seeing in Italy. I hope I'm wrong. @RUfubar's anecdotal comments and those I'm seeing from others aren't encouraging. The one thing we look to have done several days sooner than Italy is much more social distancing/closures, which should help.

https://en.wikipedia.org/wiki/List_of_OECD_countries_by_hospital_beds
 
Interesting quote on Zero Hedge tonight presented here without comment:

"The circuses have been removed.How much longer before the bread is taken away?"
 
Numbers....if you had to predict this like a snow storm. What is best case/worst case ? Mostly likely scenarios ?

I'm not qualified to say what the most likely scenario is, but I can give some possible ones and one comment - because the math is so scary, we've been in lockdown in our house for 11 days now with over a months worth of supplies - meaning we want to do our part to try to contain this, which is also part of why I've been posting so much about this here and many other places.

I've actually posted about a few scenarios numerous times. If we do nothing or even if we're simply unsuccessful at containment in the long term, meaning most of the country eventually (over the next year or so) gets the virus, which is at least a 50/50 possibility, IMO, given our very poor start in testing and identifying/quarantining infected people, then it's simple math.

If you assume that it's similarly transmissible as the flu (it's actually more transmissible) and the flu death rate is 0.1% (30-60K deaths/year usually) and the mortality rate for this is 0.5-1.0% (the range we're seeing in South Korea with very aggressive testing, so the deaths per infected people is known best there), then we'd likely see 150K-600K deaths/year in the first year.

There are also even worse case scenarios out there from the CDC, where they assume 50-70% of the 300 million US population gets the disease over a couple of years (assuming no vaccine) and the mortality rate is 0.5-1.0% that would lead to 0.75-2.0 million deaths over 2-3 years. The scenario above probably ends up at similar total deaths over multiple years.

And in both scenarios above 10X that many could need hospitalization. The only "good" news with the scenarios that large percentages of become infected is that most people who survive would then have antibodies to the virus and likely not get very sick if they get infected again, assuming the disease becomes a permanent part of the landscape.

Countries all know that these horrible scenarios are possible, which is why every country is trying very aggressive strategies for containment (except maybe the morons in the UK). On the optimistic side, with aggressive testing and very aggressive social distancing over a few months, it's possible we could have a China-like outcome with maybe tens of thousands infected and a few thousand deaths (we have a lot less people, so the numbers are lower than the 81K confirmed cases and 3120 deaths in China so far and China does appear to be getting close to containment. And if we have those numbers over a couple of months instead of a couple of weeks (like Italy) maybe we can avoid overwhelming the health care system.

The big unknown if many countries are successful in containment like China/South Korea appear to be (but not a given yet) is what happens when countries go back to "normal" social interactions and a few new cases pop up, maybe from another country where it's not contained - will they be plunged back into aggressive testing/social distancing? Probably, especially if well less than 0.01% of the population was ever seriously exposed to the virus (100K cases in China is <0.01% of over a billion people).

https://thehill.com/homenews/state-watch/487489-worst-case-coronavirus-models-show-massive-us-toll
 
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I'm not qualified to say what the most likely scenario is, but I can give some possible ones and one comment - because the math is so scary, we've been in lockdown in our house for 11 days now with over a months worth of supplies - meaning we want to do our part to try to contain this, which is also part of why I've been posting so much about this here and many other places.

I've actually posted about a few scenarios numerous times. If we do nothing or even if we're simply unsuccessful at containment in the long term, meaning most of the country eventually (over the next year or so) gets the virus, which is at least a 50/50 possibility, IMO, given our very poor start in testing and identifying/quarantining infected people, then it's simple math.

If you assume that it's similarly transmissible as the flu (it's actually more transmissible) and the flu death rate is 0.1% (30-60K deaths/year usually) and the mortality rate for this is 0.5-1.0% (the range we're seeing in South Korea with very aggressive testing, so the deaths per infected people is known best there), then we'd likely see 150K-600K deaths/year in the first year.

There are also even worse case scenarios out there from the CDC, where they assume 50-70% of the 300 million US population gets the disease over a couple of years (assuming no vaccine) and the mortality rate is 0.5-1.0% that would lead to 0.75-2.0 million deaths over 2-3 years. The scenario above probably ends up at similar total deaths over multiple years.

And in both scenarios above 10X that many could need hospitalization. The only "good" news with the scenarios that large percentages of become infected is that most people who survive would then have antibodies to the virus and likely not get very sick if they get infected again, assuming the disease becomes a permanent part of the landscape.

Countries all know that these horrible scenarios are possible, which is why every country is trying very aggressive strategies for containment (except maybe the morons in the UK). On the optimistic side, with aggressive testing and very aggressive social distancing over a few months, it's possible we could have a China-like outcome with maybe tens of thousands infected and a few thousand deaths (we have a lot less people, so the numbers are lower than the 81K confirmed cases and 3120 deaths in China so far and China does appear to be getting close to containment. And if we have those numbers over a couple of months instead of a couple of weeks (like Italy) maybe we can avoid overwhelming the health care system.

The big unknown if many countries are successful in containment like China/South Korea appear to be (but not a given yet) is what happens when countries go back to "normal" social interactions and a few new cases pop up, maybe from another country where it's not contained - will they be plunged back into aggressive testing/social distancing? Probably, especially if well less than 0.01% of the population was ever seriously exposed to the virus (100K cases in China is <0.01% of over a billion people).

https://thehill.com/homenews/state-watch/487489-worst-case-coronavirus-models-show-massive-us-toll

Thanks for the info
 
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Saw some interesting info from the CDC that upon further review there have likely been deaths due to covid in the US dating back to January that were classified as something else at the time. While that’s obviously not good, I have to wonder why there would be an explosion of cases now if it’s already been here 2 months. Also brings into question what exactly is going on in italy if this is the case. It’s almost as if there are multiple strains going around with different levels of infectiousness.
 
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Another treatment approach. My buddy (who used to be in my group at Merck and is now a VP at Regeneron!) sent me this link to an NBC piece on their elegant approach to treating and or preventing COVID-19 and they're hopeful they'll have a product in the not too distant future. It's essentially antibody therapy, where a "pseudo" coronavirus is used to elicit antibodies in mice genetically altered to mimic the human immune system and the antibodies that work best to deactivate the coronavirus are then selected and cultured in large bioreactors featuring cell lines which make enough product for the market.

The product can either be a treatment for infected patients (at higher doses) or a preventative for uninfected patients, kind of like a vaccine, except with vaccines, usually some weakened or killed virus is injected so the human body makes the antibodies to it, so that when the actual virus is encountered, the body is ready to destroy it. Since no virus is being injected (just antibodies), it should make clinical trials far simpler to run (and much easier to evaluate for safety/efficacy), although it likely would only work for several months as a preventative, which would still be great, especially for health care workers. Let's hope this approach works - it has worked for other diseases like Ebola, especially as a treatment. Other companies, obviously, are pursuing similar approaches.

https://www.nbcnews.com/…/new-york-biotech-company-working-…
 
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According to the OECD, the US is near the bottom in hospital beds per 1000 people with 2.7 per 1000, a bit below Italy (~3) and well below Germany (8) and South Korea (12). You are correct about Italy's population being older, but areas like the DC-Boston corridor are 2-3X more densely populated than Italy, so those might cancel out. I think places like NYC could end up being worse than what we're seeing in Italy. I hope I'm wrong. @RUfubar's anecdotal comments and those I'm seeing from others aren't encouraging. The one thing we look to have done several days sooner than Italy is much more social distancing/closures, which should help.

https://en.wikipedia.org/wiki/List_of_OECD_countries_by_hospital_beds

I was under the impression that ICU beds are the key metric. That link is not for ICU. If it is just hospital beds one would think many can be set up all over. Not to mention you'd have to calculate in Dr offices and urgent care that could be used / converted. The closed schools could serve as places patients could go.

I also hope they're calling in the reserves if we have a true medical capacity emergency. Anyone that went to med school should be mobilized now. This should be getting staged similar to calling up military reserves for a war.

Perhaps this is already happening, but I heard nothing about it in today's press conference and haven't seen any Dr call for it.
 
https://www.genengnews.com/a-lists/how-to-conquer-coronavirus-top-35-treatments-in-development/

List of therapies being developed for COVID-19. As mentioned in my prior posts, Remdesivir is the most advanced with data expected in April. Next is Keletra in July.

Excerpt: "The Health Commission of Henan Province announced January 31 that three confirmed cases of patients diagnosed with new coronavirus infections recovered after taking Kaletra, a combination of ritonavir and lopinavir. As of that date, nucleic acid testing of more than 20 confirmed cases of patients infected with new coronavirus, admitted to hospitals in Zhejiang Province turned negative after taking Kaletra, according to Ascletis Pharma, which is evaluating a combination therapy of its own candidates ASC09 and ritonavir."

One encouraging note based on multiple sources is that next to Remdesivir (and recently Kaletra), the other drug that is being used in China that appears to be showing very good efficacy is old malaria drug Chloroquin.

Stay vigilant - we can beat this virus.

Mixed reports on remdesivir, but they always speculate before trial results, so let's see what they say in early April. Pulling for this to work obviously, even if only in some patients.

https://www.sciencemag.org/…/did-experimental-drug-help-us-…

https://www.statnews.com/pharmalot/2020/03/13/gilead-coronavirus-covid19-clinical-trials/
 
I was under the impression that ICU beds are the key metric. That link is not for ICU. If it is just hospital beds one would think many can be set up all over. Not to mention you'd have to calculate in Dr offices and urgent care that could be used / converted. The closed schools could serve as places patients could go.

I also hope they're calling in the reserves if we have a true medical capacity emergency. Anyone that went to med school should be mobilized now. This should be getting staged similar to calling up military reserves for a war.

Perhaps this is already happening, but I heard nothing about it in today's press conference and haven't seen any Dr call for it.
Chris Cuomo's whole show tonight was dedicated to what he kept calling the need for mobilizing for this like a war. He's right. This needs everyone to contribute, especially with regard to being smart and not spreading the virus.

Probably the most important thing is actually ventilators and not beds or ICU beds and supposedly we have nowhere near enough of those.
 
It's low because they've tested so many more people, per capita than anyone else, so it's not that surprising they're finding mostly negative test results. I hope it means they're on their way to containing it, as reflected by the decrease in new cases over the past 5-6 days. Other countries with far less testing, like the US, have over 20% positive test results.
I'm not sure what kind of traffic SK gets from China. I know Samsung and Hyundai/Kia have plants in China. But China is the main sponsor of North Korea.. there might be some rather severe restrictions on movement between teh 2 countries or those borders could be tightly controlled very quickly because of the history there.

I read somewhere that SK's tests have more false positives than the cumbersome US test... but we should have taken the WHO tests and added a 2nd layer with our test for those who showed positive with teh WHO test. I'd absolutely love to know why no one involved said YES to both tests with an idea like that in mind.

My gut tells me there was some financial consideration in there somewhere... like someone was afraid that if we took the WHO test.. that some contract for the CDC created test would disappear. If there were any real journalists left out there, we'd probably have that answer by now.
 
Probably the best analysis of the situation I've read, medically, epidemiologically, and socially by Tomas Pueyo. Scary as shit, but with serious data analysis (and great graphics for visualization) behind it.

Link not working. Go to medium.com/topic/coronavirus, then click on "Coronavirus, Why We Must Act Now" for the article/data.

He basically says we're in the exponential growth phase and are about to be hammered with actual cases, since the true numbers of people walking around with the coronavirus right now are 10-30X what we've measured so far (a bit over 2000) and the only way to stem the tide once a country has reached this kind of growth rate (especially without testing insight) is lockdown.

And while he's not a medical professional/epidemiologist, he's got an MBA from Stanford and two MS's in eng'g from top European schools and is one of the best data visualization experts out there and numerous other epidemiologists are sending the same message - it's just that he's doing it in a more convincing, data-rich, easy to understand way (see the Times link below for a similar article). So while there are a few weak points in the scientific discussion (he doesn't discuss age and probably overstates some of his mortality rates), the parts about exponential growth and the need for containment (testing. tracking contacts, quarantining infected people, etc.) and mitigation/social distancing are spot on if we want to prevent a bunch of Wuhans/Italys.

https://www.nytimes.com/2020/03/13/science/coronavirus-math-mitigation-distancing.html

We're making strides but we're not in true lockdown yet. In a week, when we have 10,000 cases and hundreds dead, we'll end up in lockdown, but unfortunately it will likely be a lockdown with an overwhelmed health care system, making the mortality rates much higher than they need to be. So why not do it now if you haven't already (and are able to do so) to try to "flatten the curve" so we at least don't overwhelm our medical facilities and health care system?

Below is his intro and in the link are all the graphics and explanations. Hard to read it without saying, damn this guy really knows his science and his data. A few bulleted highlights from the detailed sections:
  • Wuhan went exponential and out of control with over a thousand "actual" (but unknown cases when they had only confirmed about 100. We've all heard how bad it got there with their lockdown
  • The rest of China learned from Wuhan and every other outbreak was contained with lockdowns that were effective before the exponential growth phase was reached and the lockdown, high testing rate, and largely unaffected medical system made for a much lower mortality rate.
  • Hong Kong, Taiwan, Singapore, Japan also never hit the exponential growth phase, as all of them were hit by SARS in 2003, and all of them learned from it. They learned how viral and lethal it could be, so they knew to take it seriously. That’s why all of their graphs, despite starting to grow much earlier, still don’t look like exponentials.
  • South Korea is an outlier in many respects. The outbreak was under control until Patient 31, who was a super-spreader who passed it to thousands of other people in Daegu. Because the virus spreads before people show symptoms, by the time the authorities realized the issue, the virus was out there. They’re now paying the consequences of that one instance, but their testing and containment efforts have paid off, as Italy and Iran have caught up to and well surpassed SK, which is now showing a significant decline in new cases.
  • Washington State is the US’s Wuhan. The number of cases there is growing exponentially and the virus had been spreading undetected for weeks. If only the CDC had allowed Dr. Chu to test those reserve flu samples in early Feb, instead of Feb 25th, when she found the virus had been spreading for weeks, undetected (when she ran the tests and shared them with the public without permission)
  • With the number of cases we see today in countries like the US, Spain, France, Iran, Germany, Japan, Netherlands, Denmark, Sweden or Switzerland, Wuhan was already in lockdown.
  • There are several stages to control an epidemic, starting with anticipation and ending with eradication. But it’s too late for most options today. With this level of cases, the two only options politicians have in front of them are containment and mitigation.
  • Containment is sure all the cases are identified, controlled, and isolated. It’s what Singapore, Hong Kong, Japan or Taiwan are doing so well: They very quickly limit people coming in, identify the sick, immediately isolate them, use heavy protective gear to protect their health workers, track all their contacts, quarantine them… This works extremely well when you’re prepared and you do it early on, and don’t need to grind your economy to a halt to make it happen.
  • Researchers estimate that the Wuhan travel ban only delayed the spread in China by 3-5 days.
  • Mitigation requires heavy social distancing. People need to stop hanging out to drop the transmission rate (R), from the R=~2–3 that the virus follows without measures, to below 1, so that it eventually dies out. These measures require closing companies, shops, mass transit, schools, enforcing lockdowns… The worse your situation, the worse the social distancing. The earlier you impose heavy measures, the less time you need to keep them, the easier it is to identify brewing cases, and the fewer people get infected. This is what Wuhan had to do. This is what Italy was forced to accept. Because when the virus is rampant, the only measure is to lock down all the infected areas to stop spreading it at once. With thousands of official cases — and tens of thousands of true ones — this is what countries like Iran, France, Spain, Germany, Switzerland or the US need to do. But they’re not doing it.
Coronavirus: Why You Must Act Now
Politicians, Community Leaders and Business Leaders: What Should You Do and When?

Tomas Pueyo


Updated on 3/13/2020. Now reflects an update on containment vs. mitigation strategies. 17 translations at the bottom. Send me more existing translations in private notes at the bottom. This article has received 21million views in the last 48h.

With everything that’s happening about the Coronavirus, it might be very hard to make a decision of what to do today. Should you wait for more information? Do something today? What?

Here’s what I’m going to cover in this article, with lots of charts, data and models with plenty of sources:

  • How many cases of coronavirus will there be in your area?
  • What will happen when these cases materialize?
  • What should you do?
  • When?
When you’re done reading the article, this is what you’ll take away:

The coronavirus is coming to you.
It’s coming at an exponential speed: gradually, and then suddenly.
It’s a matter of days. Maybe a week or two.
When it does, your healthcare system will be overwhelmed.
Your fellow citizens will be treated in the hallways.
Exhausted healthcare workers will break down. Some will die.
They will have to decide which patient gets the oxygen and which one dies.
The only way to prevent this is social distancing today. Not tomorrow. Today.
That means keeping as many people home as possible, starting now.

As a politician, community leader or business leader, you have the power and the responsibility to prevent this.

You might have fears today: What if I overreact? Will people laugh at me? Will they be angry at me? Will I look stupid? Won’t it be better to wait for others to take steps first? Will I hurt the economy too much?

But in 2–4 weeks, when the entire world is in lockdown, when the few precious days of social distancing you will have enabled will have saved lives, people won’t criticize you anymore: They will thank you for making the right decision.

Ok, let’s do this.

Share the Word
This is probably the one time in the last decade that sharing an article might save lives. They need to understand this to avert a catastrophe. The moment to act is now.


Below are a few graphics from the link, showing how big of a difference even one day's worth of social distancing can make down the road in daily new cases and eventual cumulative total cases. The article has a ton of other graphics illustrating what happened in many countries and what is expected to happen in selected countries, based on epidemiological models, incorporating what actually happened in countries that handled things similarly.

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1*4kOJv8hmd5VFPcBL1mywsw.png
 
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The problem with the "normal" flu is just that, every year it's never normal. Influenza under goes HA antigenic drift which makes it difficult for our own immune system to combat. Every year, it's a different strain. I'm sure some of these drugs have been used (or tried) for dire flu patients. But there's never a continuity year over year because of the virus' ability to be different each year.

The influenza virus is no joke. It's just that we've developed immunity to it. But in the first influenza pandemic (dubbed the "Spanish flu"), it killed 50% of the world's population. To date, according to WHO estimates, influenza kills 650,000 people annually.

fifty percent? lofl. no
 
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Another treatment approach. My buddy (who used to be in my group at Merck and is now a VP at Regeneron!) sent me this link to an NBC piece on their elegant approach to treating and or preventing COVID-19 and they're hopeful they'll have a product in the not too distant future. It's essentially antibody therapy, where a "pseudo" coronavirus is used to elicit antibodies in mice genetically altered to mimic the human immune system and the antibodies that work best to deactivate the coronavirus are then selected and cultured in large bioreactors featuring cell lines which make enough product for the market.

The product can either be a treatment for infected patients (at higher doses) or a preventative for uninfected patients, kind of like a vaccine, except with vaccines, usually some weakened or killed virus is injected so the human body makes the antibodies to it, so that when the actual virus is encountered, the body is ready to destroy it. Since no virus is being injected (just antibodies), it should make clinical trials far simpler to run (and much easier to evaluate for safety/efficacy), although it likely would only work for several months as a preventative, which would still be great, especially for health care workers. Let's hope this approach works - it has worked for other diseases like Ebola, especially as a treatment. Other companies, obviously, are pursuing similar approaches.

https://www.nbcnews.com/…/new-york-biotech-company-working-…
I work at Merck's R & D dept (building 34 in Rahway).
 
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