COVID-19 Coronavirus Containment Efforts

[wukunlin]

Georgia Democratic primary cancelled.

Big question is how the general election will play out if COVID19 still lingers in November. That could be a super spreader event nationwide.

Have heard warm weather and higher humidity MIGHT be something that wipes out the virus, as it cannot survive as well. Maybe growth and carrier rates decline in the summer. But, what about November?

Can elections even take place? They are massively cramped events, so social spacing/distancing is very hard.

Is it at all possible for the election to take place electronically? I suppose it needs a nation wide identification system, not sure how that can work in the US though?

 

[Astronuc]

If you are going to a Church, wear a face mask.

If one goes out in public, one may wish to wear a mask, because one does not know who one may encounter. Also, carry some disposable wipes with which to wipe hands that have touched high-touch surfaces. At my place of employment, sanitary practices were ramped up (increased cleaning of door handles and door knobs, and high-touch surfaces) four weeks ago in anticipation of the spread of 2019-nCoV. Hand sanitizer dispensers were placed near all building entrances.

Three weeks ago, we began doing meetings by video-conference, which has been an option for a number of years.

 

[kyphysics]

Everyone should have some hand sanitizer, but hoarders who deprive others should read this:

The week that changed lives: For one Garner family, sanitizer shortage puts a life at risk
https://www.newsobserver.com/news/local/article241193256.html

“Ma’am we don’t have any,” the pharmacist on the other end of the line replied, “and I don’t think we’ll have any for a month.”

Bethany and Jared Reeves’ 3-year-old daughter, Naomi, received a heart transplant when she was four months old. Naomi’s immune system is suppressed to keep her body from rejecting the heart, leaving her highly susceptible to colds, the flu and COVID-19, the illness caused by the new coronavirus. They need the hand sanitizer so they and their older daughter, Kathryn, can protect Naomi.

The product is important enough to Naomi’s heath that the Reeveses installed a dispenser just inside the family’s front door; visitors must use it before entering the two-story home. So when Bethany learned the sanitizer would be missing from their local pharmacy for at least a month, the hunt was on.

If you have a few months' supply - great. If you have 10 years worth and people like this cannot access any, then in emergencies like COVID19, that is practically criminal.

 

[kadiot]

EU decision (approved by Council because Commission cannot do anything without the approval of the Council members in concensus, Italy naturally included) through EU Commission which is the executive arm of the Council (issued two days ago):

COVID-19: Commission sets out European coordinated response to counter the economic impact of the Coronavirus*

.../...The Commission will use all the instruments at its disposal to mitigate the consequences of the pandemic, in particular:

- To ensure the necessary supplies to our health systems by preserving the integrity of the Single Market and of production and distribution of value chains;

- To support people so that income and jobs are not affected disproportionally and to avoid permanent effect of this crisis;

- To support firms and ensure that the liquidity of our financial sector can continue to support the economy

- And to allow Member States to act decisively in a coordinated way, through using the full flexibility of our State Aid and Stability and Growth Pact Frameworks.

https://ec.europa.eu/commission/presscorner/detail/en/ip_20_459

 

[DennisN]

Everyone should have some hand sanitizer, but hoarders who deprive others should read this:

The week that changed lives: For one Garner family, sanitizer shortage puts a life at risk
https://www.newsobserver.com/news/local/article241193256.html
If you have a few months' supply - great. If you have 10 years worth and people like this cannot access any, then in emergencies like COVID19, that is practically criminal.

That is absolutely heartbreaking.

I will try to find the email to the journalist who wrote the article to get the contact info to the family.
If I succeed I will try to locate hand sanitization and send it to them. But it would take some time for a delivery from Sweden to the US, so if anyone here reading this is in the US and have access to available hand sanitization it would go much faster.

Anyone, anyone, Bueller?

Maybe we could ask @Greg Bernhardt for advice regarding this too, that is, maybe ask members how to locate available hand sanitization, perhaps?

EDIT:

I have found the email to the reporter and I have just sent an email to him.

 

[Ygggdrasil]

Georgia Democratic primary cancelled.

Big question is how the general election will play out if COVID19 still lingers in November. That could be a super spreader event nationwide.

Have heard warm weather and higher humidity MIGHT be something that wipes out the virus, as it cannot survive as well. Maybe growth and carrier rates decline in the summer. But, what about November?

Can elections even take place? They are massively cramped events, so social spacing/distancing is very hard.

The Georgia primary was not cancelled, it was postponed to May 19: https://apnews.com/2ec895cc5ec27745f9a1b33c091be7ca

Georgia is the second state to postpone primary elections due to concerns over the virus, joining Louisiana.

Please be more careful about the facts that you report. A claim like this should include a link to a reputable news site.

Meanwhile, my home state, Illinois, is proceeding with our March 17 primary despite volunteer poll workers canceling and polling locations backing out: https://chicago.suntimes.com/politi...-county-polling-places-unprecedented-election

Luckily, suspecting things could get bad by March 17, I requested a mail in ballot a week ago, so that I can avoid having to go to a polling place.

Various states have expanded vote by mail efforts, and some states conduct their elections entirely by mail (IIRC, Oregon does this). Some states are considering conducting their primaries by mail (https://www.baltimoresun.com/corona...0200313-asebi2ahqfab7a7yxhnoayy22a-story.html), and mail in ballots could presumably be a good option in November if necessary (though if Coronavirus is still a big issue by then, perhaps we have bigger worries).

 

[kadiot]

The tests are designed to protect the public, not you.

I agree. We have been abiding by the World Health Organization's(WHO) directives regarding the management of the Covid 19 breakout. Screening, reporting, contact tracing are some of the recommendations. Testing was (and still is) a problem because of limited resources. This is a new disease that requires special testing. This caught the entire world flat footed. No one was prepared for this need. WHO did not advise outright travel bans. We did anyway, as some other countries where the number of morbidity and mortality is nevertheless staggering.

 

[Vanadium 50]

Please be more careful about the facts that you report. A claim like this should include a link to a reputable news site.

I agree.

And @kyphysics , you might want to take it down a notch about telling others what to do, given that you've told us you think you have it, and then zipped out to shop and refuse to see a doctor. Glass houses, stones, you know the drill.

 

[Ygggdrasil]

My understanding is that a test gets an incorrect result because of the patient, not because of the test. A false negative (more common) because the body just doesn't have enough right-sized virus fragments.

Do you have a source for this? I've done RT-qPCR tests in a research setting (though not in any diagnostic capacity), and false positives/negatives due to issues with the sample (not the patient) seem more common (e.g. taking more sample from the patient can resolve issues with inconsistent tests).

It's certainly possible that patient-specific false negatives could arise due to mutations in the virus that render it undetectable by current tests (which probe for specific RNA sequences within the viral genome), but it seems like these are likely rare events (the mutation rate of coronaviruses seems fairly low and the sequences chosen as targets for the tests are in highly evolutionarily conserved regions of the virus that should not mutate frequently).

 

[WWGD]

That is absolutely heartbreaking.

I will try to find the email to the journalist who wrote the article to get the contact info to the family.
If I succeed I will try to locate hand sanitization and send it to them. But it would take some time for a delivery from Sweden to the US, so if anyone here reading this is in the US and have access to available hand sanitization it would go much faster.

Anyone, anyone, Bueller?

Maybe we could ask @Greg Bernhardt for advice regarding this too, that is, maybe ask members how to locate available hand sanitization, perhaps?

They don't seem to have left a contact.

 

[DennisN]

They don't seem to have left a contact.

I have found the email address to the reporter via my google-fu, and I sent an email to him about a minute ago.

 

[WWGD]

I have found the email address to the reporter via my google-fu, and I sent an email to him about a minute ago.

Ok, please post if you get it. Good job.

 

[Vanadium 50]

Do you have a source for this?

My doc. He also said, and this seems sensible to me, that the higher the accuracy level, the more that false positives/negatives depend on the patient over the sample.

 

[DennisN]

Ok, please post if you get it. Good job.

Thanks! Will do.

 

[atyy]

Do you have a source for this? I've done RT-qPCR tests in a research setting (though not in any diagnostic capacity), and false positives/negatives due to issues with the sample (not the patient) seem more common (e.g. taking more sample from the patient can resolve issues with inconsistent tests).

It's certainly possible that patient-specific false negatives could arise due to mutations in the virus that render it undetectable by current tests (which probe for specific RNA sequences within the viral genome), but it seems like these are likely rare events (the mutation rate of coronaviruses seems fairly low and the sequences chosen as targets for the tests are in highly evolutionarily conserved regions of the virus that should not mutate frequently).

My doc. He also said, and this seems sensible to me, that the higher the accuracy level, the more that false positives/negatives depend on the patient over the sample.

https://jamanetwork.com/journals/jama/fullarticle/2762688

Take a look at Figure 2 in the above article, a quick glance at the PCR Ct values seems to support @Ygggdrasil's guess - in a given patient one can have ND (non-detectable) values even with previous and subsequent days above detectability.

BTW, I don't think the statement from @Vanadium 50's doc can be generally right, because if a full sequence is done, I would expect essentially 100% accuracy with no false negatives for any patient (but with false negative for particular samples from a patient). The only thing is of course that a full sequence is not a sort of test you run on massive numbers of people (@Ygggdrasil please correct if wrong)

 

[Vanadium 50]

because if a full sequence is done

I've never sequenced DNA myself, but I believer you are correct that a full sequence is not a sort of test you run on massive numbers of people. While the JAMA article was interesting, I'm not sure how it connects to false negatives or positives.

 

[Janus]

Is it at all possible for the election to take place electronically? I suppose it needs a nation wide identification system, not sure how that can work in the US though?

In my state (Oregon), we vote entirely by mail.

 

[atyy]

I've never sequenced DNA myself, but I believer you are correct that a full sequence is not a sort of test you run on massive numbers of people. While the JAMA article was interesting, I'm not sure how it connects to false negatives or positives.

My guess is that an ND on one day where the previous and subsequent days are positive would be a false negative sample in a positive patient.

 

[homeylova223]

A John Hopkins doctor say there might be up to 500,000 infected in the USA.No this can't be true.
This is the news article https://news.yahoo.com/marty-makary-on-coronavirus-in-the-us-183558545.html. The doctor name is Makaray here is website https://www.jhsph.edu/faculty/directory/profile/1565/martin-a-makary

According to Makary this is going to the worst public health crisis since polio. People need to take this virus seriously.

 

[homeylova223]

No no no we are running out of toilet paper where I live this virus is terrible.

 

[homeylova223]

According to

 

[atyy]

A John Hopkins doctor say there might be up to 500,000 infected in the USA.No this can't be true.
This is the news article https://news.yahoo.com/marty-makary-on-coronavirus-in-the-us-183558545.html. The doctor name is Makaray here is website https://www.jhsph.edu/faculty/directory/profile/1565/martin-a-makary

A quick estimate by Trevor Bedford is between 10,000 to 40,000.

 

[DennisN]

Ok, please post if you get it. Good job.

Since I am wannabe internet spy*, I have managed to find the home address of the family anyway.
(I haven't yet got an email from the journalist).

* Which anyone could have done, but it takes some time, luck and a bit of brains.

EDIT: And I have now also located the mother of the family on facebook, so I will send her a message now.

 

[bhobba]

If one goes out in public, one may wish to wear a mask, because one does not know who one may encounter.

It only protects others if the wearer has it. Its value depends entirely on how many people are not symptomatic or have symptoms so mild you do not even notice it. So far the consensus has been that its not worth it - but our knowledge is changing fast.

Thanks
Bill

 

[phinds]

If you have a few months' supply - great. If you have 10 years worth and people like this cannot access any, then in emergencies like COVID19, that is practically criminal.

Why is the word "practically" in that sentence?

 

[bhobba]

Maybe we could ask @Greg Bernhardt for advice regarding this too, that is, maybe ask members how to locate available hand sanitization, perhaps?

Just use soap. I don't get this hand sanitizer thing. Yes you can have it on your desk and its convenient from that point of view - but its just convenience - not a necessity.

It's becoming likely the real issue here is decision makers do not understand exponential growth and do not take decisions early enough, not the lack of non-essential items like hand sanitizes. Today I decided to stock up a bit more on meat and veg. Not much veg - but I did find some. Meat was funny. Hardly any - except for expensive cuts of which there was tons. I bought a few thick cut on the rib steaks. This is an emergency - penny pinching on meat cuts - beats me.

Thank
Bill

 

[chemisttree]

In memoriam for the lost and seriously afflicted everywhere.

 

[bhobba]

Georgia is the second state to postpone primary elections due to concerns over the virus, joining Louisiana.

We have local elections soon. The council announced Coronavirus will not be an excuse for not voting (here in Aus we have compulsory voting). Normally you have long lines at the polling booths. You think people will listen when the government has announced social distancing of at least three feet is now required. Talk about mixed messages. I will drive to the polling booth and see the line. If it is as I think it will be I will drive home and see what silliness they try on those who did not vote - if they dare.

Thanks
Bill

 

[DennisN]

Just use soap. I don't get this hand sanitizer thing. Yes you can have it on your desk and its convenient from that point of view - but its just convenience - not a necessity.

I can assure you I will give the mother advice regarding safety learned from WHO and this thread when I get in contact with her.

 

[morrobay]

Have there been any documented cases of infection from surfaces like rails at malls and public transportation? There can be exposures but not in high enough numbers to be infectious.

 

[Jarvis323]

Doesn't one just self-isolate until one is no longer symptomatic, maybe a day extra if one wants to be cautious?

The transmission of COVID-19 from asymptomatic individuals is generally thought to be negligible.

My understanding is no?

Recent evidence suggests that even someone who is non-symptomatic can spread COVID-19 with high efficiency, and conventional measures of protection, such as face masks, provide insufficient protection.

https://www.thelancet.com/journals/...Djw5x0wmu9XZaooHRlZmqQq8PBtm2UJ4mWzQ80sJa_JxU

A well 6-month-old infant with Coronavirus disease 2019 (COVID-19) had persistently positive nasopharyngeal swabs to day 16 of admission. This case highlights the difficulties in establishing the true incidence of COVID-19 as asymptomatic individuals can excrete the virus. These patients may play important roles in human-to-human transmission in the community.

https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa201/5766416

"Asymptomatic and mildly symptomatic transmission are a major factor in transmission for Covid-19," said Dr. William Schaffner, a professor at Vanderbilt University School of Medicine and longtime adviser to the CDC. "They're going to be the drivers of spread in the community."

https://www.cnn.com/2020/03/14/health/coronavirus-asymptomatic-spread/index.html

I have trouble finding out how long one needs to self-quarantine if they have the virus. For a patient known to have it, they would stay until the test came up negative on consecutive days. I found one source:

Overall, viral load above detection limit was detected until 14 and 25 days after symptoms onset and for 13 and 11 days after the first detection, respectively.[7]

https://www.journalofhospitalinfection.com/article/S0195-6701(20)30102-X/pdf

 

[bhobba]

@bhobba , what do you mean by "taking a Biologic", I wonder?

Ok - a little information about treating Auto immune diseases of which the most common are Rheumatoid Arthritis, Psoriasis including Psoriatic Arthritis, Lupus etc. I have heard about 10% of the population have them. Its caused by a malfunctioning immune system. The treatment is to suppress your immune system. For years the Folic Acid antagonist Methotrexate has been used for that. I have been taking it for nearly 20 years. But about 15 years ago a new drug appeared - Enbrel - the first of a new type of drug called Biologics. A mediator for your immune system is called Tumor necrosis factor or TNF. Enbrel is a bio-engineered drug to render TNF inert. It really suppresses your immune system - as my Rheumatologist said its like putting a superhighway through it - especially when combined with Methotrexate. Your incidences of cold and flu rise dramatically - I forget what it is but the one I currently take is 5 times the incidence and it's supposed to be much less than Enbrel. I refused to take it for that reason even though my Rheumatologist pushed me. But new Biologics with less side effects started to appear and my Rheumatologist finally convinced me to take a new one called Cosentex specifically designed for Psoriasis which has only a .1% infection rate and you only get 5 times more colds and flu. That's why you must get the flu vaccine with it - if I get the flu I am in deep do-do. I get colds more frequently than normal but they are usually, but not always, quite mild. Now since my immune system has never seen this new coronovirus before and I now have a superhighway through it the chances of me fighting it off is severely reduced. As I said 10% have autoimmune diseases and hence compromised or suppressed immune systems, so take that into account when hearing 80% come through the new coronovirus just fine. That's of no consolation to them at all.

Thanks
Bill

 

[TeethWhitener]

https://jamanetwork.com/journals/jama/fullarticle/2762688

Take a look at Figure 2 in the above article, a quick glance at the PCR Ct values seems to support @Ygggdrasil's guess - in a given patient one can have ND (non-detectable) values even with previous and subsequent days above detectability.

BTW, I don't think the statement from @Vanadium 50's doc can be generally right, because if a full sequence is done, I would expect essentially 100% accuracy with no false negatives for any patient (but with false negative for particular samples from a patient). The only thing is of course that a full sequence is not a sort of test you run on massive numbers of people (@Ygggdrasil please correct if wrong)

Based on what little info I’ve found about available tests, they’re not doing full sequences. This test from Applied Biosystems:
https://www.fda.gov/media/136112/download
uses three primers from different regions of the viral genome to reduce cross-reactivity (IOW, to reduce the false positive rate).

 

[phinds]

Have there been any documented cases of infection from surfaces like rails at malls and public transportation? There can be exposures but not in high enough numbers to be infectious.

One of the CDC people said on TV that the virus can last several days on hard, polished surfaces, particularly metal.

 

[StoneTemplePython]

Ok - a little information about treating Auto immune diseases of which the most common are Rheumatoid Arthritis, Psoriasis including Psoriatic Arthritis, Lupus etc. I have heard about 10% of the population have them. ...
As I said 10% have autoimmune diseases and hence compromised or suppressed immune systems, so take that into account when hearing 80% come through the new coronovirus just fine. That's of no consolation to them at all.

Just a couple other thoughts. (Possibly duplicating earlier posts in this thread -- where I've read things on covid19... blurs together)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2527069/

Autoimmune diseases are overwhelmingly concentrated with women -- 78% of the cases (and estimated 8% of global population has some autoimmune disease). At a crude level my understanding is autoimmune disease translates to overactive immune system that results in a lot of 'friendly fire' to your body.

Covid19 deaths I think skew towards men which contrasts markedly with nearly 80% of autoimmune diseases being with women. Now diabetes, high blood pressure and many other things are also risk factors. The open question for your doctor of course is whether the biologic dosing should come down during this.