COVID-19 Coronavirus Containment Efforts

[mfb]

@Vanadium 50: Nice analysis.

Two comments:

Out of the 712 infections, 145 were among the crew and 567 among the passengers. If you limit the extrapolation of deaths to the older passengers you should do this with infections as well, increasing the deaths by ~20%.

The 15 million people will normally have 45,000 hospital beds, out of these 15,000 free, and 5,000 total ICU beds if the US average applies to NYC. If 20,000 die then about 60,000 will need an ICU bed, 30,000 of them will need a ventilator, and 100,000 to 300,000 will get pneumonia, taking ratios from China. If these are not available then the case fatality rate will go up. The Diamond Princess cases all had access to hospitals.
If the areas around NYC see weaker outbreaks they can take some patients from NYC. If they see similar outbreaks this won't work.

 

[bhobba]

As far as I know other countries consider something similar.

As soon as the serology test is available here in Aus, that is exactly what they are looking at. I have even heard talk they might be 'encouraged' into front line work with hospitals, the elderly etc. I hope that encouragement is just that - the last thing we want here with all the restrictions we currently have is some kind of 'forced' conscription.

Thanks
Bill

 

[bhobba]

Unfortunately, no. Usually flu comes with much lower death rate and in this vaccianation actually makes no difference: that effects only the R0 value.
Novel flu can do something similar, at least we know a case when it did.

- Knucklehead - of course you are right - the vaccine mainly just affects R0. In may have a bit of an effect on death rate in that it is reported if you are vaccinated your case is generally milder if you do manage to get it. Well back to the drawing board. The spanish flu had a death rate of 2% - higher than the current flu strains floating around and it seems higher than Coronovirus. Excluding the Ruby Princess debacle our death rate has increased from .4% to .6% which is slightly concerning and the government wants to do more local testing to see if it's just the quarantining in hotels of those arriving in Australia lowering the denominator. But it looks like its death rate is not as bad as the Spanish flu. Interestingly the swine flu had a phenomenally low death rate - estimated 0.001% to 0.007%

Thanks
Bill

 

[bhobba]

While writing my last post something occurred to me. The timeline it took to get the Swine Flu vaccine was research started April 2009 and a vaccine became available December 2009. Why is the Coronovirus vaccine taking longer? We had many vaccines in a few weeks during January - the UQ vaccine took just 3 weeks. So it would seem testing is taking longer - why is that?

Thanks
Bill

 

[Rive]

Why is the Coronovirus vaccine taking longer?

For flu vaccines, the already proven (safe, working) technology remains the same, only the strain(s) changes so a shortened, rapid trial is acceptable. But for the Covid19 an entirely new technology is needed: the approval process is a lot more complicated and longer.

...The spanish flu had a death rate of 2%...

Well, actually we don't know that, not exactly. Flu also can be asymptomatic, and I don't know if/how that was accounted in that number.
And without the asymptomatic cases, we are in the same range with the Covid19 too.

 

[kyphysics]

An at-home fingerprick blood test may help detect your exposure to coronavirus
If approved, the blood test could show if your immune system has developed Coronavirus antibodies. But a positive result isn't a license to return to work.

https://www.nbcnews.com/health/heal...elp-detect-your-exposure-coronavirus-n1176086

I am greatly hoping this is fast-tracked. I would want to know for me and my family if we've been exposed and may have immunity or not.

A Los Angeles digital healthcare company called Scanwell Health is seeking U.S. government clearance for a kit that let's users submit a scanned image of a blood test to doctors via their phones. Within a few hours, according to the company, the user will learn whether the blood contains antibodies for coronavirus.

"The entire testing process happens at home," says Scanwell Chief Medical Officer Jack Jeng, "No specimen has to be shipped back."

A positive test result means a patient has been exposed to COVID-19 at some point in the past and has developed antibodies to fight it.

"The Scanwell rapid serology test is looking for antibodies in the blood. A positive test result means that you were exposed to the virus previously because it takes time for the antibodies to develop," said Jeng.

David Kroll, a professor of pharmacology at the University of Colorado who has worked on antibody testing, explained that the antibodies mean "your immune system [has] remembered the virus to the point that it makes these antibodies that could inactivate any future viral infections."

What the test can't do is tell you whether you're currently sick with coronavirus, whether you're contagious, whether you're fully immune — and whether you're safe to go back out in public.

Because the test can’t be used as a diagnostic test, it would need to be combined with other information to determine if a person is sick with COVID-19.

"However, when combined with symptoms consistent with COVID-19 like a fever, cough, and sore throat, a positive test is pretty much diagnostic for the illness," said Jeng, "That is how these rapid serology tests are being used in China."

Does anyone know how to interpet the bolded part? Would anti-bodies not tell us we're fully immune already?

 

[atyy]

An at-home fingerprick blood test may help detect your exposure to coronavirus
If approved, the blood test could show if your immune system has developed Coronavirus antibodies. But a positive result isn't a license to return to work.

https://www.nbcnews.com/health/heal...elp-detect-your-exposure-coronavirus-n1176086

I am greatly hoping this is fast-tracked. I would want to know for me and my family if we've been exposed and may have immunity or not.

A Los Angeles digital healthcare company called Scanwell Health is seeking U.S. government clearance for a kit that let's users submit a scanned image of a blood test to doctors via their phones. Within a few hours, according to the company, the user will learn whether the blood contains antibodies for coronavirus.
Does anyone know how to interpet the bolded part? Would anti-bodies not tell us we're fully immune already?

You usually need a certain level of antibodies to be protected. So if you have antibodies, but only a low level, you may not be protected.

The test may not be a quantitative test, so it may not be able to say whether you have a low or a high level of antibodies. Also, we probably don't know at this stage what "minimum" level is needed to be protected.

You can see these considerations in more common vaccines like Hepatitis B and tetanus vaccination. The antibody level may decrease over time, and one may need a booster vaccination.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5512724/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4826453/

 

[Astronuc]

Does anyone know how to interpet the bolded part? Would anti-bodies not tell us we're fully immune already?

That is a disclaimer. Scientifically, the test determines the presence of antibodies, which would indicate exposure and infection, but it does not determine whether you're currently sick with Coronavirus (one would need to measure temperature (fever) and other symptoms (X-ray for lung opacity, measure oxygen level in blood)), whether you're contagious (test doesn't measure viriods or virus being exhaled, for example), whether you're fully immune (more complicated testing required).

 

[kyphysics]

That is a disclaimer. Scientifically, the test determines the presence of antibodies, which would indicate exposure and infection, but it does not determine whether you're currently sick with Coronavirus (one would need to measure temperature (fever) and other symptoms (X-ray for lung opacity, measure oxygen level in blood)), whether you're contagious (test doesn't measure viriods or virus being exhaled, for example), whether you're fully immune (more complicated testing required).

Any idea if tests for full immunity can even be theoretically created right now?

Or, is it too early?

 

[kyphysics]

You usually need a certain level of antibodies to be protected. So if you have antibodies, but only a low level, you may not be protected.

The test may not be a quantitative test, so it may not be able to say whether you have a low or a high level of antibodies. Also, we probably don't know at this stage what "minimum" level is needed to be protected.

You can see these considerations in more common vaccines like Hepatitis B and tetanus vaccination. The antibody level may decrease over time, and one may need a booster vaccination.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5512724/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4826453/

Thanks for the helpful reply!

 

[Astronuc]

Any idea if tests for full immunity can even be theoretically created right now?

Or, is it too early?

There are journal articles and textbooks on "Measuring immunity" or "immune response", for example, https://link.springer.com/article/10.1007/s00204-016-1809-5
or https://www.elsevier.com/books/measuring-immunity/lotze/978-0-12-455900-4

So apparently, there are techniques to determine immunity, and ostensibly a method can be developed to determine immunity to SARS-Cov2.

 

[peanut]

France not reached peak yet amid nearly 9,000 dead; outdoor physical exercises banned from 10AM to 7PM in Paris

 

[peanut]

Cities That Went All In on Social Distancing in 1918 Emerged Stronger for It
By Emily Badger and Quoctrung BuiApril 3, 2020

They had lower mortality rates from the influenza pandemic. But their economies also appeared to fare better.

https://www.nytimes.com/interactive...4rR58teby8YisItGJJ0JkKte0yTSb98UDmKMCCFSEI0OA

 

[TeethWhitener]

Stupid question: does certifying recovered patients to return to work create an incentive for others to try to expose themselves to the disease?

If you really need to be back in the workforce to support yourself/your family, but the only way you can get back to work is to have recovered from covid-19, then you may end up concluding that risking a 1 in 5 chance of serious illness is preferable to almost certainly being out of work for an indefinite but prolonged period of time.

 

[Rive]

Stupid question:...

I do know about some who actually considered this.
I do not think that it is a good idea.
I think this kind of thing should be considered crime.

 

[mfb]

Stupid question

Government policies might reduce that incentive, but it's an interesting question.

You can bring back economic growth. You can't bring back dead people.

Today I learned that the president of Ghana https://www.thelondoneconomic.com/politics/president-of-ghana-provides-much-needed-perspective-in-these-troubling-times/29/03/ almost literally a week ago.

----

https://annals.org/aim/fullarticle/2764367/effectiveness-surgical-cotton-masks-blocking-sars-cov-2-controlled-comparison

In conclusion, both surgical and cotton masks seem to be ineffective in preventing the dissemination of SARS–CoV-2 from the coughs of patients with COVID-19 to the environment and external mask surface.

Italy's new cases are the lowest number in three weeks:

 

[Astronuc]

I was just listening to New York governor Andrew Cuomo give his daily update. He mentioned a coordinated effort with the state of New Jersey. Cuomo mentioned an increase in deaths, which is a lagging indicator compared to hospitalizations, for which the three-day average has decreases. Cuomo mentioned last week that the longer someone is on a ventilator, the less likely they will come off the ventilator, which is still the case, and he mentioned that some patients had been on ventilator for 20 to 30 days.

Cuomo talked about availability of beds, the capacity of which has increased. On the other hand, a local county has one ICU bed available and the will be filled soon before the end of the week. Discharges from hospital have increased, so some folks are recovering.

NY state has reported 138836 positive cases and 5489 deaths so far.

Before Cuomo spoke, a reporter for a regional news service (covering NY, CT, MA and VT) mentioned that there was a cluster of deaths and positive COVID-19 at some senior living (retirement) centers. In one case, people who were tested negative last week have since developed symptoms of COVID-19. It was not clear if they have been retested.

 

[Astronuc]

Yes. Though there is very LITTLE data on any kind of ASYMPTOMATIC transmission precisely because these people are hard to identify. PRESYMPTOMATIC transmission does seem to occur and may be responsible for probably up to 10% of transmission. The MAJORITY (about 90%) of transmission STILL seems to occur from symptomatic individuals.

Caroline Chen, April 2, 6 a.m. EDT
https://www.propublica.org/article/...ic-carriers-if-were-going-to-beat-coronavirus
What We Need to Understand About Asymptomatic Carriers . . .

With articles about “silent spreaders” and “stealth transmission” flying across the internet, friends were starting to text me: Was it still OK to go for a walk with a friend, even 6 feet apart? Or should all interaction be avoided? Should we start wearing masks to the grocery store? At the same time, my colleagues were scrutinizing guidelines at various workplaces and agencies we cover: The New York City Fire Department told workers on March 19 they were to come to work, so long as they had no symptoms, even if they had had “close contact with someone who is a known positive COVID-19 patient,” according to a document obtained by ProPublica. Was that policy wise?
. . . .
What does asymptomatic really mean?
Let’s start with the basics. Dr. Maria Van Kerkhove, head of the emerging diseases and zoonoses unit at the World Health Organization, told me that the WHO so far has found few truly asymptomatic cases, in which a patient tests positive and has zero symptoms for the entire course of the disease. However, there are many cases where people are “pre-symptomatic,” where they have no symptoms at the time when they test positive but go on to develop symptoms later.

“Most of the people who were thought to be asymptomatic aren’t truly asymptomatic,” said Van Kerkhove. “When we went back and interviewed them, most of them said, actually I didn’t feel well but I didn’t think it was an important thing to mention. I had a low-grade temperature, or aches, but I didn’t think that counted.”

The article mentions a WHO study in China and a CDC study of a nursing home in Washington state (probably the Life Care Center in Kirkland).

 

[kolleamm]

does the microwave kill the virus?

 

[phinds]

does the microwave kill the virus?

Why would it matter? If you got the virus, would you plan on dousing your body with microwaves?

Shooting microwaves at surfaces might not be quite as dangerous as that, but would likely be dangerous. Cataracts, anyone?

 

[vela]

Why would it matter? If you got the virus, would you plan on dousing your body with microwaves?

Shooting microwaves at surfaces might not be quite as dangerous as that, but would likely be dangerous. Cataracts, anyone?

I think the question might have been if you can disinfect objects by nuking them.

 

[phinds]

I think the question might have been if you can disinfect objects by nuking them.

Jeez, vela, nuclear bombs are definitely overkill.

 

[Vanadium 50]

Jeez, vela, nuclear bombs are definitely overkill.

But if it saves Just One Life...

 

[BillTre]

Relevant info (with respect to cloth masks) from the eyebank I work for:

There are different ways to clean these cloth masks:

1. Soak in HOT BOILING water and let air dry
2. Dip in 91% alcohol and let air dry
3. Put in microwave for 20 or so seconds

 

[kolleamm]

Relevant info (with respect to cloth masks) from the eyebank I work for:

There are different ways to clean these cloth masks:

1. Soak in HOT BOILING water and let air dry
2. Dip in 91% alcohol and let air dry
3. Put in microwave for 20 or so seconds

Then out of all those the microwave seems to be the most practical.
(Assuming the object has no metal parts)

 

[phinds]

Then out of all those the microwave seems to be the most practical.
(Assuming the object has no metal parts)

Does that damage/degrade the elastic?

 

[Rive]

Does that damage/degrade the elastic?

Maybe no, but may stink

 

[OmCheeto]

Then out of all those the microwave seems to be the most practical.
(Assuming the object has no metal parts)

My guess, based on the following video, is that the masks must be either completely soaked with water,



or contained in some type of microwave steamer/sterilizer.

In any event, the microwaves don't/won't destroy the viruses directly, it's the heat that does the job.

 

[anorlunda]

Stupid question: does certifying recovered patients to return to work create an incentive for others to try to expose themselves to the disease?

Yeah, that is why having documentary evidence that you are recovered would be important.

Unfortunately, everyone is scrambling so much to prevent spread and to care for the sick, I expect that near zero effort will be provided to those recovered. They probably never will get documentation.

Example, in Florida the government unemployment benefits office is completely overwhelmed with new applications. Then the governor offered help from 25000 other state employees to help with processing those applications, employees like police, highway maintenance, social workers, prison guards, and so on. That is a sign of desperation.

 

[kyphysics]

Synthetic antibodies might offer a quick Coronavirus treatment

In the search for a treatment for COVID-19, researchers are exploring a wide range of approaches, including antibiotics (which ordinarily aren’t effective against viruses), a drug used for malaria (also not a virus) and of course the gold standard for viral disease, a vaccine (which is probably at least a year away). Another approach is to harvest antibodies, protective substances produced in response to an infection, from the blood plasma of people who have been infected.

That, however, is a slow process, and there are no guarantees it will work; you have to recruit patients to donate plasma, and then collect and process it into a form that can be used therapeutically.

Dr. Jacob Glanville, one of the researchers featured in the Netflix documentary “Pandemic: How to Prevent an Outbreak,” thinks he has found a shortcut. Glanville is the president of Distributed Bio, a computational immunoengineering group that focuses on making antibody therapeutics and vaccines. For weeks, Glanville and his team braved long shifts in the lab to engineer a possible treatment for COVID-19, and last Wednesday, April 1, he announced via Twitter that they had achieved a breakthrough. Yahoo News spoke to the scientist that evening.

“For the last nine weeks we have been working on creating an antibody therapy to neutralize and therefore cure the novel Coronavirus in patients who need it.”

Antibodies are proteins that are produced by the immune system to help stop intruders and pathogens, such the coronavirus, in order to prevent sickness and harm.

“We are engineering very specific antibodies that are really good at this, to be able to go block the virus.”

Glanville told Yahoo News that in order to save time and arrive at these results, he went back to antibodies that had proven effective 18 years ago in the fight against SARS.

https://www.yahoo.com/news/syntheti...-a-quick-coronavirus-treatment-132122036.html

Any thoughts, guys?

Later the article says:

It also is effective immediately, Glanville said. “With a vaccine, that shot has little pieces of the virus in it, and so when you get injected with it, your immune system starts to learn how to attack those pieces of the virus, and that takes time; that takes many weeks, might be six or seven weeks before you have protection with an antibody. With a therapeutic, that syringe or IV bag contains the antibodies directly. So when they infuse it into you, your body doesn't need to do anything.”

Despite these benefits, a vaccine is still the gold standard. “A vaccine could give you a year, even up to five years of protection, where an antibody, when you inject them into your body, they only really last about eight weeks, maybe 10 weeks,” Glanville explained.

[moderator: gaudy red font removed.]

 

[kyphysics]

My thought is sometimes having something is better than nothing as we wait for a vaccine.

 

[atyy]

https://www.yahoo.com/news/syntheti...-a-quick-coronavirus-treatment-132122036.html

It's a similar idea to blood plasma treatment, where we give a patient plasma from people who have recovered because the plasma has antibodies against the virus. It could work, but I think it will also have to go through the whole safety and efficacy testing for approval, which will be slow. Antibody treatments are also typically very expensive. So this will not be a "quick treatment".

 

[bhobba]

Why would it matter? If you got the virus, would you plan on dousing your body with microwaves?

Shooting microwaves at surfaces might not be quite as dangerous as that, but would likely be dangerous. Cataracts, anyone?

I think it's about something like a plastic container, where a virus can live for 72 hours, when used as a container to heat food, if it gets killed. Heat kills it, so it's highly likely so does microwaves.

Thanks
Bill

 

[bhobba]

Any thoughts, guys?

Worth a try.

Thanks
Bill

 

[kyphysics]

Antibody treatments are also typically very expensive. So this will not be a "quick treatment".

Many health insurers are waiving COVID-19 treatment costs. Not sure if they'd cover preventative costs, but if it really is going to be expensive, I do hope the U.S. government can have grants for it.