COVID-19 Coronavirus Containment Efforts

[Ygggdrasil]

NYC and LA will no longer test for possible cases but only use tests for determining the appropriate course of treatment of symptomatic persons. This is due to lack of PPE and tests. According to CNN. Is this a good strategy?

Given that NYC and LA are under stay at home orders, it is probably ok to not perform widespread testing in order to conserve both human and testing resources (though for those who are not staying at home, e.g. people working critical jobs, like grocery store clerks, testing should be made available). However, once the shelter in place ends, we better have widespread testing available, or all of the work of the lockdown will likely go down the drain.

 

[nsaspook]

https://www.aljazeera.com/news/2020...border-shutdowns-country-200318091505922.html

 

[Keith_McClary]

They showed footage of Chinese being forcibly removed from their homes.

A woman who tested positive for COVID-19 was arrested in Quebec City after she left isolation
Saturday, March 21, 2020

During the recently declared public health emergency, Quebec’s Public Health Act gives authorities greater powers if someone jeopardizes public health. Premier Francois Legault declared the 10-day emergency Mar. 14.

 

[zoki85]

https://www.digitaltrends.com/news/israel-seeks-to-track-phone-data-for-coronavirus/

LoL, Corona is killing privacy in Israel. Except getting permission from cell-phone providers, The Government must have special software to do such thing

 

[OmCheeto]

I suspect the wide "global" disparity in case fatality rates might be due to countries/locales being overwhelmed.

Possible

The following just came across my Facebook feed:

Margie Boulé; "I have a high school friend who has lived in Italy for decades. She’s been giving advance notice of what we can expect soon. Two hours ago she reported today’s statistics — and please be aware that, according to my friend, the death stats may be wrong because “some hospitals are so overwhelmed that they have stopped counting the dead.” Remember, this is just one month from when they had their first reported case:​

..."​

-----------------------------

Margie is a retired local news person

[of the highest quality, IMHO.
Her coverage of the local Pertussis outbreak in 2003 was second to none.]

[Edit]
I was worried about the legality of not asking Margie for permission to quote her, so I went back and discovered this:

Margie; "Pray for Italy. Pray for us all. AND STAY HOME.​

Please comment and share, so more people will see this."​

​

Bolding is obviously mine, as I haven't yet figured out how to bold on Facebook.

 

[Vanadium 50]

I'm not sure "heard it from a friend who heard it from a friend who heard it from another" meets PF standards, but...

This was quoted in the NY Post two days ago. (We can discuss whether the Post is a reputable source or not) However, the fact is that Italy is counting its dead. 3/17-3/21 is 345, 475, 427, 627, and 793. To compare, typical deaths in Italy are about 1800 per day. So while an individual hospital may certainly be overwhelmed (like the Seattle nursing home) I'd like to see more evidence before I believe the entire country is.

To be fair, there are some missed days in the counting from particular regions and the statistics show up in the following day. (e.g. 60-0-192-97-95)

 

[Astronuc]

Some US statistic as of this morning:

US statistics 3/21 17:14 ET (Coronadashboard has 25,239 positive, 297 deaths)
23,203 positive
156,017 negative
179,220 total test results
3,477 pending w/ tests
1,964 hospitalized
272 deaths

NY Statistics Last updated: 3/20 21:22 ET • Last checked: 3/21 16:10 ET
10,356 positive
35,081 negative
45,437 total test w/ results
1,603 pending
44 deaths

WA Statistics Last updated: 3/20 18:00 ET • Last checked: 3/21 15:24 ET
1,524 positive
21,719 negative
23,243 total test w/ results
85 deaths

CA Statistics Last updated: 3/21 00:00 ET • Last checked: 3/21 15:50 ET
1,279 positive
11,249 negative
12,528 total test w/ results
24 deaths

Numbers change rapidly as pending tests are confirmed positive/negative and new folks are tested.
The cases in WA slowed, as have those in CA, but NY area has taken off exponentially.
According to the Coronadashboard site, with 25,239, the US is poised to overtake Spain with total cases, but fewer deaths as of today. That can change as the virus spreads into areas where the populations do not adopt stay-at-home, which is the only practical defense to prevent infection until a vaccine is available. There is no approved treatment, such as an antiviral, but there are some drugs that may have potential, such as an anti-malarial drug (not yet verified) and remdesivir (Gilead). There are 8 vaccines under development, and several treatments.

 

[phinds]

... typical deaths in Italy are about 1800 per day.

From all the reports I've read, that's WAY more than their average. The biggest jump they've had was, as I recall, yesterday and it was about 700 so the average would be lower than that, not 1800.

 

[Vanadium 50]

Italy has a population of 60.5M and an annual death rate of 1.1%. That's 665K per year. 665K per year is 1800/day.

 

[phinds]

Italy has a population of 60.5M and an annual death rate of 1.1%. That's 665K per year. 665K per year is 1800/day.

Oh, I thought you meant from the virus.

 

[Mary Conrads Sanburn]

Coronavirus Live Updates

LATEST NEWS AND 1 HR AGO

FDA Approves First Rapid COVID-19 Test

by VANESSA ROMO

The Food and Drug Administration has approved the first rapid point-of-care COVID-19 test, that can deliver results in less than an hour.

Cepheid, a Silicon Valley diagnostics company, made the announcement on Saturday, saying it has received emergency authorization from the government to use the test.

While the agency has approved about a dozen other COVID-19 tests in response to the public health emergency caused by the Coronavirus pandemic, this is the first one that can be used at the point of care.

Cepheid said the test kits will be available by the end of the month.

[. . .]

2 HRS AGO

Inspired By Italy, Dallas Residents Sing Together From Their Apartment Windows

by LYNSEY JEFFERY

In these uncertain times, we all need somebody to lean on.

Or so felt the residents of South Side on Lamar, an apartment building in Dallas, Texas, where a group of residents stuck their heads out of windows in a chorus of quarantined voices.

Building resident and soulful tenor Danzel Barber led an apartment quarantine singalong to the popular Bill Withers song "Lean on Me."

Little by little, other residents began to join Barber in his refrain, some adding harmonies, some just peering out their windows or filming on phones. Others came in a bit off-beat or off-key — the perils of cross-apartment singing.

North Texas member station KERA reported the story, and longtime contributor Mark Birnbaum, who lives in the building, caught the singalong on camera.

[ . . .]

https://www.npr.org/sections/coronavirus-live-updates#id819603870

 

[Klystron]

I fell behind following the latest updates due to minor surgery Friday. Today my Canadian friends and neighbors wintering here in the desert received immediate evacuation orders. Two couples I know are flying back to Canada tonight with just hours notice. A loss to our community IMO.

The surgery center practiced social distancing by directing patients and drivers to wait in their vehicles. Patients were provided hand sanitizer but not masks. Medical staff wore masks, gowns and surgical gloves. Admin clerks wore optional light masks and latex gloves. Patient post-op escorts changed gloves and booties after each trip.

Most patients willingly complied with distancing but at least one woman my age repeatedly berated the clerks for being asked to wait in her car; a new luxury Mercedes that I noticed as it occupied two parking places.

If PF allows a poetic analogy, a common cold compares to influenza as a face slap is to being chain-whipped and stomped by irate bikers. I get the recommended flu vaccine each year as a precaution. Stay safe.

 

[atyy]

Earlier in this thread @Ygggdrasil posted links to articles by (1) Tomas Pueyo and by (2) Neil Ferguson and colleagues. I'm linking those articles here, along with (3) a new article by Pueyo which includes commentary on Ferguson's article, and (4) a Twitter thread by Trevor Bedford which also comments on Ferguson's article. The important points added by the third and fourth articles are that draconian measures resembling those taken in Wuhan may not be needed for more than a few months, as the example of South Korea shows.

Coronavirus: Why You Must Act Now
Politicians, Community Leaders and Business Leaders: What Should You Do and When?
Tomas Pueyo, 10 March 2020

Impact of non-pharmaceutical interventions (NPIs) to reduce COVID-19 mortality and healthcare demand
Neil Ferguson and colleagues on behalf of Imperial College COVID-19 Response Team , 16 March 2020

Coronavirus: The Hammer and the Dance
What the Next 18 Months Can Look Like, if Leaders Buy Us Time
Tomas Pueyo, 20 March 2020

Comments on 16 March paper by Imperial College COVID-19 Response Team
Trevor Bedford, 19 March 2020

 

[Roberto Teso]

I would like to share with you all an ingenious work that has been developed here in Italy, an emergency mask for hospital respirators made in very ingenious way, you can find all the instructions (italian and english) here:

EASY COVID 19

I hope as soon as possible to find a similar method to produce masks such as FFP2 and FFP3.

Stay united, even if at a safe distance, and take care of yourself and your loved ones.

 

[DennisN]

As some of you may be aware of, the death toll in Italy¹ is now greater than in China, and further efforts are now being considered in Italy:

Italy Coronavirus deaths jump by almost 800, government shuts most workplaces (Reuters, March 21, 2020)

ROME (Reuters) - Italy recorded a jump in deaths from Coronavirus of almost 800 on Saturday, taking the toll in the world’s hardest-hit country to almost 5,000.

In its latest desperate effort to halt the epidemic Rome ordered that all businesses must close until April 3, with the exception of those essential to maintaining the country’s supply chain.

“It is the most difficult crisis in our post-war period,” Prime Minister Giuseppe Conte said in a video posted on Facebook, adding “only production activities deemed vital for national production will be allowed”.

Conte did not specify which factories and businesses will be considered crucial to keep the country going. The government is expected to publish an emergency decree on Sunday to make the new crackdown immediately effective.

Here in Sweden it has been announced² that our prime minister will do a special address to the public this evening. This is very unusual and very rarely happens in Sweden.

Sources:
1. Coronavirus COVID-19 Global Cases by the Center for Systems Science and Engineering (CSSE)
2. Löfven håller tal till nationen i kväll (SVD, Swedish only)

 

[jack action]

Here's what the former chief medical officer of Ontario (Canada) had to say about the containment effort, today:

https://www.cbc.ca/player/play/1714367043854

The actual interview was longer and, at one point, he went back on these mathematical models that present catastrophic scenarios.

His point - which is also mine - is that these are very weak as they are basically modelling things with a lot of unknowns, which makes these models very unreliable. He was stating that he thoughts the modelers don't put enough emphasizes on that fact.

Scientifically illiterate politicians and news people really like those type of crude scientific observations that have a shock value. Personally, I'm more worried about what people will think later on science based on these type of crude observations that can misrepresent reality, and will extend that opinion to well-established science based on well defined facts. The difference between the two might be difficult to distinguish for the untrained eye.

 

[bhobba]

NYC and LA will no longer test for possible cases but only use tests for determining the appropriate course of treatment of symptomatic persons. This is due to lack of PPE and tests. According to CNN. Is this a good strategy?

IMHO - no. I certainly can understand things like that without enough tests, but surely the answer is this is only an interim measure and we will as a priority do everything possible to get more tests. If it overwhelms the medical system do what some other places are doing - isolating those infected in hotels etc that are now vacant because of lockdowns.

Thanks
Bill

 

[bhobba]

Latest news - PM has announced Australia is close to lockdown - not quite there yet but every commentator says it soon will be - likely in the next week.

Here in Queensland its basically levelled off - over the last few days between 35-40 cases daily, but the two main states NSW and Victoria, are advancing exponentially.

Thanks
Bill

 

[anorlunda]

https://www.latimes.com/california/story/2020-03-20/coronavirus-county-doctors-containment-testing

The [Los Angeles County Department of Public Health] “is shifting from a strategy of case containment to slowing disease transmission and averting excess morbidity and mortality,” according to the letter. Doctors should test symptomatic patients only when “a diagnostic result will change clinical management or inform public health response.”

The guidance sets in writing what has been a reality all along. The shortage of tests nationwide has meant that many patients suspected of having COVID-19 have not had the diagnosis confirmed by a laboratory.

In addition to the lack of tests, public health agencies across the country lack the staff to trace the source of new cases, drastically reducing the chances of isolating people who have been exposed and thereby containing the outbreak.

 

[peanut]

French Parliament voted last night to give Govt powers to declare State of Health/Sanitary Emergency: the text of the law will allow the Govt to adopt the necessary measures "to limit the freedom to come and go, the freedom to do as one pleases and the freedom to assemble but for the sole purpose of putting a stop to the health catastrophe..."

The text of the proposed law will have to go to the Senate. A lively debate between members of the National Assembly and the Senate is expected. Mr Schellenberger of the Liberal Party is expecting a lively debate between members of the National Assembly and the Senate and expects both Chambers to come to a compromise because he says, "such law will give the Government collossal power."

https://www.lefigaro.fr/politique/c...5Pc30RiXZ5mr5AUdqqDtppaL3FV5O1TYW4yTgnwqGzcAs

 

[phinds]

Sounds like the French are taking Patrick Henry literally, but out of context.

 

[Keith_McClary]

This is your chance to save the world by sitting on your butt watching TV. Don't screw it up.

 

[peanut]

Sounds like the French are taking Patrick Henry literally, but out of context.

If French authorities abuse the provisions in the law, there will be hell to pay.

Edit: The US DoJ is asking for something more RADICAL.

https://www.yahoo.com/entertainment...s-205444026.html?soc_src=social-sh&soc_trk=fb

 

[PeroK]

As some of you may be aware of, the death toll in Italy¹ is now greater than in China, and further efforts are now being considered in Italy:

Italy Coronavirus deaths jump by almost 800, government shuts most workplaces (Reuters, March 21, 2020)

The Italian death rate seems very high. Much higher than predicted for the virus and much higher than other countries. Is there any information on why this is?

 

[phinds]

The Italian death rate seems very high. Much higher than predicted for the virus and much higher than other countries. Is there any information on why this is?

One thing is that Italy has the highest percent of elderly in Europe according to news reports

 

[PeroK]

One thing is that Italy has the highest percent of elderly in Europe according to news reports

It can't be fundamentally different from the other major European countries.

 

[phinds]

It can't be fundamentally different from the other major European countries.

You're probably right but here's one news article about it:
https://www.wired.com/story/why-the-coronavirus-hit-italy-so-hard/

 

[gleem]

Italy/ Germany have the second largest elderly population in the world second to Japan. But Japan is doing well with the virus. Also, Italian culture depends on a lot of contact between the young and the old. The EU has the largest regional aging population in the world.

 

[gmax137]

... twerp ...

Thanks -- I haven't heard that word in a long time!

 

[Vanadium 50]

One thing is that Italy has the highest percent of elderly in Europe according to news reports

Tied with Finland at 36.6. (This is the elderly dependency ratio, defined as N(65+)/N(15-64) ) Japan is a clear outlier at 48.0.

It can't be fundamentally different from the other major European countries.

Europe ranges from 36.6 to 20.5 (Luxembourg). Luxembourg is not an outlier - Cyprus is 20.9, Ireland is 22.6, Montenegro is 23.8.

 

[gleem]

The US just became number one in the world for daily increases in new cases, over 11,000 today doubling up on Italy"s 5500. https://www.worldometers.info/coronavirus/#countries

Should overtake China and Italy in total cases by Friday.

 

[gleem]

3M says that they have upped production of N95 masks to 1.1 billion/year double its previous rate. There are 4 million nurses and physicians and maybe another 2.5 million other health care workers with patient contact in this country. At the current rate, the masks should be hitting the streets at 3.0 million per day. So why the shortage if they have been producing them at 1.5 million per day previously?

As far as price gouging is concerned most hospitals buy from high profile distributors whose pricing practices are easily monitored. So why aren't states enforcing unfair/deceptive trade practice laws?

Edit: I made a mistake by a factor of 10 in production . Has been corrected. Still with judicious use BS allocation, there should not be a shortage for hospitals or healthcare workers

 

[Ygggdrasil]

The Italian death rate seems very high. Much higher than predicted for the virus and much higher than other countries. Is there any information on why this is?

A few reasons why the observed case fatality rate my be high:
1) Population demographics (as others have noted)
2) (Also as noted previously) Behavioral differences (e.g. greater intergenetational mingling which leads to more infection of elderly, prevalence of smoking which exacerbates the condition, etc.)
3) Lack of testing (case fatality rate is deaths/infected cases; if testing is not identifying mild cases, then the denominator of the rate calculation is wrong and the cfr will appear to be too high).
4) Lesser healthcare resources (Italy has many 2x fewer hospital beds per capita than Germany, see graph posted here, which means much less capacity to treat severe cases).
5) Related to above, an overwhelmed health care system (so many severe cases that would be treatable in a normal setting are leading to death because of shortages of key equipment like ventilators).

 

[Klystron]

3M says that they have upped production of N95 masks to 1.1 billion/year double its previous rate. There are 4 million nurses and physicians and maybe another 2.5 million other health care workers with patient contact in this country. At the current rate, the masks should be hitting the streets at 30 million per day. So why the shortage if they have been producing them at 15 million per day previously?

As far as price gouging is concerned most hospitals buy from high profile distributors whose pricing practices are easily monitored. So why aren't states enforcing unfair/deceptive trade practice laws?

No information on price gouging but 3M N95 face masks are very popular in my area among a variety of professionals and hobbyists. Local hardware stores sell (or sold?) contractor boxes of 20 respirators* at a discount. My current box of 20 has part number 8200HB1. A different part number packages 4 masks in 5 or 25 bundles intended for professional painters, shop workers, construction, cooks and cleaners to carry throughout the work day to change masks as they become clogged with dust and perspiration.

I always keep a box handy for dusty cleanup chores, fine art painting preparation, smoking/BBQ and other tasks that involve dust particles. I did not know medical professionals used N95 masks until this recent crisis, assuming they used surgical respirators and softer (cloth ?) masks.

So, consider adding the number of cleaners and other workers to your count along with the many professions that use similar masks and that the paper masks require frequent replacement.

*(3M labels them as respirators.)

 

[DennisN]

Here in Sweden it has been announced that our prime minister will do a special address to the public this evening. This is very unusual and very rarely happens in Sweden.

The address of the prime minister was about the crisis in general, he talked about our shared resposibilities and that we will have to be prepared for that the difficult time will last for a while. There was no announcement of any new policies regarding the virus situation, but he said that new policies may come, and may come quickly.