COVID-19 Coronavirus Containment Efforts

In summary, the Centers for Disease Control and Prevention (CDC) is closely monitoring an outbreak of respiratory illness caused by a novel (new) Coronavirus named 2019-nCoV. Cases have been identified in a growing number of other locations, including the United States. CDC will update the following U.S. map daily. Information regarding the number of people under investigation will be updated regularly on Mondays, Wednesdays, and Fridays.
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  • #2,733
DennisN said:
I just read a long interview with Dr. Michael Osterholm (an infectious disease epidemiologist) regarding his thoughts about the near future and possible long term developments of this pandemic including possible future numbers, multiple waves, comparison with the waves of the Spanish flu in 1918 and many other things. It was a very sobering read. To be honest, I found it was a quite scary read, which actually made me hesitate about posting it here. But I decided to post it:

Another interesting interview.
 
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  • #2,734
bhobba said:
If that's what will happen, then of course it's fine. But nothing along those lines was mentoned.
How else would you perform a vaccine trial? Just giving the vaccine to people isn't sufficient, you need to check what happens.
 
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  • #2,735
mfb said:
How else would you perform a vaccine trial? Just giving the vaccine to people isn't sufficient, you need to check what happens.

Good point - when you do not let your emotions get the better of you and think more clearly.

Thanks
Bill
 
  • #2,736
nsaspook said:
Another interesting interview.

Informative - yes - and many truths such as the real death rate of about .1% - which is what is now generally accepted. But he did not mention the bogeyman of R0 I have mentioned before. For me that's the real problem and issue. It gets into a closed environment and watch out. Here in Aus a worker was asymptomatic or had extremely mild symptoms (as many are thought to have - hence the lowering of the death rate from about 1-.5% to .1%) and here is what happened:
https://www.abc.net.au/news/2020-04-29/how-western-sydney-newmarch-house-got-coronavirus/12196444

He correctly asks about the exit strategy, but dismisses the obvious one - wait for the vaccine. At least two groups working on a vaccine (the Oxford and UQ ones) say September (80% confidence for the Oxford one - it's the new timeline for the UQ one since they found out it is very effective as per another post I did - I will try and post that in a separate post). It's costly, risky, and very courageous, but Australia has more or less decided on it.

As the person being interviewed says - we will see in a years time - if I am still alive. Because if it fails here in Aus, (because due to the cost of a lockdown it is unbelievably damaging to the economy), I am on the front line.

Thanks
Bill
 
  • #2,737
When is COVID pandemic going to end ?
Read on.
—-
I think everyone has the same question in their minds: When is the Coronavirus - also known as COVID-19 - pandemic going to end?

And it’s a very valid question because we seem to be getting conflicting answers from researchers and scientist. Some of us do understand that these things are not easily measurable, and it looks like the only answer we’re getting is that we have to wait it out.

But a projection done by the Singapore University of Technology and Design (SUTD) might shed some light on when we can expect the virus to be eradiated in a particular country.

The information comes from the use of A.I. technology and world data from Our World in Data. The data include total confirmed cases, total deaths, new confirmed cases, new deaths, and population data.

https://sea.mashable.com/tech/10314...hen-coronavirus-will-end-heres-the-exact-date
 
  • #2,738
Here is a precis of the article in the local newspaper on what the UQ vaccine team latest timeline is after their success in creating a strong immune response.

'Buoyed by the latest results UQ scientist Professor Trent Munro admitted having a vaccine in production before the end of the year was “incredibly ambitious”, but that was the goal the UQ team had set itself. It could be in large-scale production by the September quarter.

Professor Munro said scientists internationally were working with “an awful lot of collaboration” in the race to find a vaccine amid the worst pandemic in a century. “People are sharing data faster than we’ve ever seen before,” he said. “Everyone’s trying to move as fast as they can.”

UQ scientists warn issues such as distribution, manufacturing it into vials and having enough data from human trials to receive regulatory approval would have to be worked out before people could start to be inoculated on a broadscale basis, with the elderly and frontline health workers likely to be prioritised.

“Our goal is to demonstrate scalability and to produce as many doses as we can and we’ve obviously done the calculations to think we can generate tens of thousands, hundreds of thousands, even potentially millions of doses,” Professor Munro said.

“What happens with those doses, what kind of people are able to use those … all those questions remain. “We’re on track,” he said with regard to human trials. “Stay tuned for some further announcements.”

Dr Chappell said the vaccine was expected to work against different strains of SARS-CoV-2, explaining that it did not evolve as quickly as the flu. “We think we should provide broad spectrum protection against all strains that are around at the moment and should emerge in future,” he said.'

My comment is this strategy is very risky with no guarantee of success, but the payoff is big if it works. Otherwise what the Swedish epidemiologist said is the likely outcome - god help us. Sweden has 2,462 deaths at the moment, compared to about 90 in Australia - even though Australia has about 2.5 times the population.

Thanks
Bill
 
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  • #2,739
bhobba said:
Informative - yes - and many truths such as the real death rate of about .1% - which is what is now generally accepted. But he did not mention the bogeyman of R0 I have mentioned before.

Would just the greater rate of spread of COVID-19 compared to influenza explain why the health systems in Wuhan, Northern Italy and New York City have been overwhelmed?

Currently NYC has about 15,000 deaths.
Antibody testing estimates about 20% of NYC might have COVID (estimate might be a bit high, but it's ok)
NYC population is 8,500,000.
The death rate would be about 100% x 15000 x (0.2 x 8,500,000) ~ 0.8%
 
  • #2,740
atyy said:
Would just the greater rate of spread of COVID-19 compared to influenza explain why the health systems in Wuhan, Northern Italy and New York City have been overwhelmed?

Partly at least. Combine it with it circulating mostly with very mild symptoms or even asymptomatic, plus no testing, and it's a timebomb waiting to explode. When it gets past the exponential 'knee' without testing and confinement you can see the results:
https://www.vox.com/policy-and-poli...s-us-countries-italy-iran-singapore-hong-kong

Taiwan had no 'knee' to speak of because it started testing and confinement early - the US exploded. Interestingly because the testing was early the number of tests per million in Taiwan was low compared to other countries - it didn't explode. Even the Swedish epidemiologist seemed unable to fit Taiwan into his view. I think Australia wants to be like Taiwan and await the vaccine. It's courageous, costly, and risky IMHO, but the payoff is huge - if you can do it. Bye the bye testng in Australia is greater than any country listed, and set to increase. While we are now doing nearly as well as Taiwan, but Taiwan with the lowest testing is still the best. We are about as good as NZ who did a stage 4 lockdown, but we only did a stage 2-3 and will be slowly reducing to stage 2 or lower.

Thanks
Bill
 
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  • #2,741
atyy said:
Would just the greater rate of spread of COVID-19 compared to influenza explain why the health systems in Wuhan, Northern Italy and New York City have been overwhelmed?
Regarding the health system load I think the main part is the average care required by a patient. With 10 percent of the infected to spend a month or more in hospital (don't know the exact average) it is an enormous load.
 
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  • #2,742
bhobba said:
Otherwise what the Swedish epidemiologist said is the likely outcome - god help us. Sweden has 2,462 deaths at the moment, compared to about 90 in Australia - even though Australia has about 2.5 times the population.
bhobba said:
Taiwan had no 'knee' to speak of because it started testing and confinement early - the US exploded. Interestingly because the testing was early the number of tests per million in Taiwan was low compared to other countries - it didnt explode. Even the Swedish epidemiologist seemed unable to fit Taiwan into his view. I think Australia wants to be like Taiwan and await the vaccine. It's courageous, costly, and risky IMHO, but the payoff is huge - if you can do it.
On the positive side, my thoughts are that the actions and results of Australia (and other countries like New Zealand) also may have bought those countries some valuable time to do additional preparations, like increasing the number of available hospital beds and intensive care units, perhaps? I don't know, I'm sort of thinking out loud here :smile:.
 
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  • #2,743
DennisN said:
Reuters reports today that UK and Italy researchers are investigating some suspicious symptoms in children:
French and Swedish news are reporting that the same suspicious symptoms in children are being seen in France:

Swedish news article said:
PARIS. In France, at least twenty children between the ages of 5 and 15 are now receiving hospital care for serious inflammatory symptoms in the heart muscle, among other things. Similar reports are coming from the UK, Spain and Italy.

Many of the children have been tested positive for covid-19, but so far it is unclear if there is a relationship.

[...]

"The clinical picture is sometimes similar to Kawasaki's disease, an inflammatory childhood disease that can affect the heart," says Pierre-Louis Léger, head of the intensive care unit for children and young people at Trousseau Hospital in Paris, to Le Monde.

[...]

In total, the numbers are about at least a hundred cases in six countries, according to The Guardian. So far, no cases have been reported in Sweden.

In all six countries, the authorities urge the public to calm down, as so far there are very few cases in relation to the total number of infected covid-19. In France, for example, the approximately 20 cases found can be compared to the approximately 26,800 people currently receiving hospital care for Covid-19 in the country.

[...]
(Google translation to English)

Sources:

Coronavirus : questions autour d’une hausse de cas de syndromes inflammatoires infantiles (Le Monde, 29 april 2020, French only)

Ny sjukdom som drabbar barn misstänks ha koppling till covid-19 (DN, 29 april 2020, Swedish only)

The Swedish article linked to the French article, so I posted a link to the French one too, even though I don't understand French. Well, I understand some French, but not very much.
 
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  • #2,745
atyy said:
Would just the greater rate of spread of COVID-19 compared to influenza explain why the health systems in Wuhan, Northern Italy and New York City have been overwhelmed?

Currently NYC has about 15,000 deaths.
Antibody testing estimates about 20% of NYC might have COVID (estimate might be a bit high, but it's ok)
NYC population is 8,500,000.
The death rate would be about 100% x 15000 x (0.2 x 8,500,000) ~ 0.8%
The 0.1% is obviously a global estimate prediction, there will be lots of places like NYC, Madrid or Lombardy with many times that death rate.
 
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  • #2,747
Astronuc said:
April 22, 2020
Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area
https://jamanetwork.com/journals/jama/fullarticle/2765184
Compounding hypertension, one of the three main comorbidities , (diabetes and obesity) Are the two prevalent antihypertensive medications. ACEi and ARB can increase mRNA expression of cardiac angiotensin - converting enzyme ACE2.
 
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  • #2,748
bhobba said:
Here is a precis of the article in the local newspaper on what the UQ vaccine team latest timeline is after their success in creating a strong immune response.

'Buoyed by the latest results UQ scientist Professor Trent Munro admitted having a vaccine in production before the end of the year was “incredibly ambitious”, but that was the goal the UQ team had set itself. It could be in large-scale production by the September quarter.
...

This is an opinion piece from the NYT.
How Long Will a Vaccine Really Take?
https://www.nytimes.com/interactive/2020/04/30/opinion/coronavirus-covid-vaccine.html
The grim truth behind this rosy forecast is that a vaccine probably won’t arrive any time soon. Clinical trials almost never succeed. We’ve never released a Coronavirus vaccine for humans before. Our record for developing an entirely new vaccine is at least four years — more time than the public or the economy can tolerate social-distancing orders.

But if there was any time to fast-track a vaccine, it is now. So Times Opinion asked vaccine experts how we could condense the timeline and get a vaccine in the next few months instead of years.

Here’s how we might achieve the impossible.
 
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  • #2,749
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  • #2,750
I heard on the radio today that sources from Wuhan are suggesting that there is some reasonably long lasting immunity to the virus. Up until now, there has been gloomy suggestions that immunity is either short lived or non-existent.
Can we be at all optimistic about the quality of the Chinese news?
 
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  • #2,751
nsaspook said:
This is an opinion piece from the NYT.

We find two views on this - those working on it are often upbeat - those not working on it are more cautious. Fingers crossed the first group is right otherwise the posted interview with the Swedish epidemiologist is the likely outcome - not good.

Thanks
Bill
 
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  • #2,752
DennisN said:
You're welcome!
Dennis - how have you been?

Have you had any "lingering" symptoms of possible COVID-19 we had previously talked about?

Three days ago, I could barely breathe. I literally was struggling to breathe as if someone had closed my airways by 60% or so. It was odd. I wasn't even moving much and found it hard to breathe. Even drinking and eating were difficult. The moment I opened my mouth to try to drink something, I was gasping for air. I could barely eat. I felt like I had sprinted to the point of needing a lot of air whenever eating or just moving. I had to literally sit still to have air that felt relaxed. Otherwise, I was gasping.

I felt weak as well. Then a day and half later or so, everything felt great. It was an 180 turn-around. It was SO odd.

Wondering if you felt anything like that. I ask, because I came across this article:
https://www.cnbc.com/2020/05/01/cor...cribe-symptoms-that-last-a-month-or-more.html

Coronavirus patients describe symptoms that last a month or more
The doctors treating Covid-19 patients say it’s possible some patients will experience lingering symptoms of the virus for a month or more.

People with mild cases typically recover in 10 to 14 days. But when the virus travels to the lungs and causes pneumonia, recovery may take six weeks or longer.

Really wondering if I had it, because I've had sudden days where I've had a non-stop cough. Then, it'd go away a few days later...and come back...and repeat the cycle. It's totally bizarre. There were two very scary moments when I considered going to the E.R. The first was back in March when I felt I literally could not raise my arms. I had massive fatigue, cough, and a burning sensation in my chest/throat/gut.

The second was just a few days ago when I had the breathing issue and felt very tired as well. It's just this sudden weakness that is bizarre and coupled with other stuff. Anyhow, hope you're doing well.

Was just curious if you've experienced any recurring weird stuff is all.
 
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  • #2,753
You thought you had it on March 13th. You think you have it now. Looks like we have evidence that a past infection doesn't confer immunity.
 
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  • #2,754
U.S. Coronavirus Death Toll Is Far Higher Than Reported, C.D.C. Data Suggests
https://www.nytimes.com/interactive/2020/04/28/us/coronavirus-death-toll-total.html
Total deaths in seven states that have been hard hit by the Coronavirus pandemic are nearly 50 percent higher than normal for the five weeks from March 8 through April 11, according to new death statistics from the Centers for Disease Control and Prevention. That is 9,000 more deaths than were reported as of April 11 in official counts of deaths from the coronavirus.

The new data is partial and most likely undercounts the recent death toll significantly. But it still illustrates how the Coronavirus is causing a surge in deaths in the places it has struck, probably killing more people than the reported statistics capture. These increases belie arguments that the virus is only killing people who would have died anyway from other causes. Instead, the virus has brought a pattern of deaths unlike anything seen in recent years.
Around the world, the Coronavirus is bringing large waves of mortality. In Spain, deaths over the last month are 66 percent higher than normal, according to New York Times reporting. In Ecuador, they are more than 80 percent higher than normal. In Paris, more than twice as many people are dying every day as normal — far more than during a typical bad flu season.

Eventually, we will get more clarity about all of the reasons that people died this year. While no mortality statistics are ever perfect, the Centers for Disease Control and Prevention uses detailed death certificates to code the causes of death for everyone who dies each year in the United States. But that process typically takes more than a year to complete.
https://www.cdc.gov/nchs/nvss/vsrr/covid_weekly/
https://data.cdc.gov/NCHS/Weekly-Counts-of-Deaths-by-State-and-Select-Causes/muzy-jte6
https://data.cdc.gov/NCHS/Weekly-Counts-of-Deaths-by-State-and-Select-Causes/muzy-jte6/data

System overwhelmed: Dozens of Decomposing Bodies Found in Trucks at Brooklyn Funeral Home
https://www.nytimes.com/2020/04/29/nyregion/bodies-brooklyn-funeral-home-coronavirus.html
he had used the trucks for overflow storage, but only after he had filled his chapel with more than 100 corpses.
his parlor had been unable to purchase a refrigerated trailer because of shortages
five other funeral homes use his storefront space, which, he said, caused him to be overwhelmed as deaths in New York reached a peak this month. Each of the other homes, he said, were in charge of as many as 30 or 40 bodies.
 
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  • #2,755
New approach from Garvan Institute here in Aus. From both a newspaper and an interview I saw.

'An antibody injection for COVID-19 is being developed by Australia’s Garvan Institute and it could help keep people out of intensive care and protect health workers. Work on the treatment is advanced and human clinical trials are due to begin later this year. Unlike the antibodies from the blood plasma of patients who have recovered from COVID-19, these monoclonal antibodies are genetically engineered in a laboratory and will be fine tuned to bind tightly to COVID-19’s spike proteins and stop the virus in its tracks.'

https://www.garvan.org.au/research/diseases/covid-19/research

Thanks
Bill
 
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  • #2,756
https://www.cidrap.umn.edu/sites/default/files/public/downloads/cidrap-covid19-viewpoint-part1.pdf
Key points from observing the epidemiology of past influenza pandemics that may provide insight into the
COVID-19 pandemic include the following. First, the length of the pandemic will likely be 18 to 24 months, as
herd immunity gradually develops in the human population. This will take time, since limited serosurveillance
data available to date suggest that a relatively small fraction of the population has been infected and infection
rates likely vary substantially by geographic area. Given the transmissibility of SARS-CoV-2, 60% to 70% of the
population may need to be immune to reach a critical threshold of herd immunity to halt the pandemic (Kwok
2020).
This may be complicated by the fact that we don’t yet know the duration of immunity to natural SARS-CoV-2
infection (it could be as short as a few months or as long as several years). Based on seasonal coronaviruses,
we can anticipate that even if immunity declines after exposure, there may still be some protection against
disease severity and reduced contagiousness, but this remains to be assessed for SARS-CoV-2. The course of
the pandemic also could be influenced by a vaccine; however, a vaccine will likely not be available until at least
sometime in 2021. And we don’t know what kinds of challenges could arise during vaccine development that
could delay the timeline.
 
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  • #2,757
bhobba said:
We find two views on this - those working on it are often upbeat - those not working on it are more cautious. Fingers crossed the first group is right otherwise the posted interview with the Swedish epidemiologist is the likely outcome - not good.

Thanks
Bill

From the NYT piece.
At this point you might be asking: Why are all these research teams announcing such optimistic forecasts when so many experts are skeptical about even an 18-month timeline? Perhaps because it’s not just the public listening — it’s investors, too.
 
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  • #2,758
Few infections, no deaths - 'And then, boom': Outbreak shows shaky ground as Texas opens
https://apnews.com/490aee062b36ab64c76c624f9674a89c

Only a handful of the 50,000 residents here, right on the border with Oklahoma, had tested positive for the coronavirus. None had died.
. . . .
Then an outbreak at a nursing home turned up over the weekend.

Now at least 65 people are infected, and everything has changed.
One person transmitted to another who transmitted to another . . . and boom.

https://www.nytimes.com/interactive/2020/world/coronavirus-maps.html
 
  • #2,759
sophiecentaur said:
I heard on the radio today that sources from Wuhan are suggesting that there is some reasonably long lasting immunity to the virus. Up until now, there has been gloomy suggestions that immunity is either short lived or non-existent.
Can we be at all optimistic about the quality of the Chinese news?

The gloomy suggestions are partly due to the WHO cautioning against assuming immunity. Their statement was strictly right that we don't know exactly what antibody levels confer what levels of protection. However, their statement mis-communicated to the public a gloomy view. In fact the WHO's main concern, which is correct, was that antibody testing which often has a high false positive rate might be dangerously used to issue immunity passports.

The WHO has since issued a new statement clarifying that they do expect recovery from COVID-19 to provide some level of protection.

Work still needs to be done, but experiments with convalescent plasma indicate that people are currently still hopeful that blood from people who have recovered can be used to treat others.
https://www.pnas.org/content/117/17/9490
https://www.pbs.org/wgbh/frontline/article/convalescent-plasma-therapy-coronavirus-covid-19/

A study has found low levels of antibodies in some people who have recovered, but it may be that their bodies have immunity by mechanisms other than those assayed.
https://www.medrxiv.org/content/10.1101/2020.03.30.20047365v2
https://www.bbc.com/news/health-52446965
"A study of 175 recovered patients in China showed 30% had very low levels of these neutralising antibodies.
That is why the World Health Organization says "that cellular immunity [the other part of the adaptive response] may also be critical for recovery"."
 
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  • #2,761
Regarding the prospects for adaptive immunity from COVID-19:

In studies with monkeys, infection with COVID-19 provides immunity to the disease in the short term, suggesting that re-infection is unlikely or rare and that a vaccine should be able to produce immunity. A bigger concern may be that our body's immune response to the virus can wane over time. Our experience with the four other endemic coronaviruses suggests that infection provides short term immunity that wanes over time, and studies on people who were infected by the similar SARS virus from the 2003 outbreak also suggests that levels of antibodies against the virus wane over the course of a few years. A non-peer-reviewed pre-print looking for the presence of antibodies in the blood of those with confirmed COVID-19 infections found that up to ~1/3 had low or no detectable antibodies (mostly from people who had mild cases), which could be a concern for the possibility of re-infection. However, as @atyy mentioned, it is not clear whether these antibody tests truly reflect immunity, and it is possible that some of the people with low/no detectable antibodies still have immunity, but the particular test is not able to detect the antibodies.

Current evidence suggests that the mutation rate of the virus is slow enough that we should not expect that the virus will mutate to avoid immunity. Of course, mutations can be unpredictable, so mutation to avoid immunity is always a possibility, though something that can be monitored.

Here's a good summary of what we know regarding immunity to COVID-19 from STAT news: https://www.statnews.com/2020/04/20...nity-and-antibodies-and-plenty-we-still-dont/
 
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  • #2,762
atyy said:
Article about Christian Drosten, a German virologist

The Coronavirus czar
By Kai Kupferschmidt
https://science.sciencemag.org/content/368/6490/462
From the article:
Drosten concedes it has surprised him, despite his 17 years of work on coronaviruses and his knowledge of the threat they pose. “I didn't think that SARS would come back like this,” he says—as a virus that is both deadly and much more transmissible. It is adept at infecting cells of the upper respiratory tract, from which a cough can expel it, and unlike SARS—but like the flu—it can spread before symptoms emerge. “That's pretty astonishing,” Drosten says.

Drosten says a key reason for SARS-CoV-2's success may be a tiny part of the “spike,” the protein that sits on the virus' surface and makes it look like a crown when seen through a microscope. The spike protein attaches to a receptor on human cells called angiotensin-converting enzyme 2. Before the virus can enter the cell, however, a part of the protein has to be cleaved. The SARS-CoV-2 spike protein cleaves more readily than equivalent proteins in other coronaviruses, because it has evolved something called a polybasic cleavage site, which Drosten likens to the perforations on a notepad that make it easier to rip off a page. That feature may explain the virus' rapid spread from cell to cell, he says.

Drosten started to warn of the new virus' potential in TV interviews in January, but quickly grew exasperated. After long interviews, journalists often used one short quote that failed to convey the immense threat, he says.
 
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  • #2,763
Regarding immunity, perhaps like susceptibility, some (perhaps many) will obtain immunity and others will not.
 
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  • #2,764
kyphysics said:
Dennis - how have you been?
Quite fine, thanks for asking!

kyphysics said:
Have you had any "lingering" symptoms of possible COVID-19 we had previously talked about?
No, nothing that has been significant. I've had a bit of a sore throat a couple of times, but it has been really minor. And I suspect that I am on a heightened level of awareness of bodily symptoms due to the pandemic, so I can't really tell if the sore throat was really particularly sore at those times, or if it was an effect of my heightened awareness. So, if there was any symptom, it was very minor, barely noticeable.

kyphysics said:
Three days ago, I could barely breathe.
(etc)
[...]
I'm sorry to hear that. The symptoms you describe match - as far as I know - some of the symptoms of people that have had Covid-19 (difficulty breathing, fatigue, coughing). Another symptom is fever. Do you have a thermometer at home? If not, if I were you I would get one, just in case. And maybe you should have a talk with healthcare about your symptoms? Maybe you could get a test?

And about experiencing "waves" of symptoms... I have definitely heard about that. Earlier in March I watched an interview with a British man who had Covid-19 in Wuhan, in which he described the waves of symptoms. In his case, they got worse with each "wave". Also please note that symptoms may vary between different persons, of course! Here's the interview:

Coronavirus survivor reveals what it's like to have Covid-19 (Channel 4 News, Mar 10, 2020)
Take care, and stay safe! :smile:
 
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Yes, the media seems to have discovered "excess deaths". (Maybe they've been reading PF). The problem with excess deaths is that it is an upper bound: one can look at last year at this time in Europe and there were 100,000 excess deaths before there was Covid. Presumably this is flu.

The European numbers today are about 120,000 identified deaths and 160,000 excess deaths. Some of the difference is surely Covid and some (especially early on) is surely flu.
 
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