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11 March 2020

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Eric Newhill

JJackson,
I am also arguing that you have no idea that this is true - "For COVID we have a current crude CAR (clinical attack rate) of 135k/7.8B "

Nor do you really know what it is for seasonal flues.

Only the worst cases present to healthcare providers and become included in the statistic. Generally, with the flu, people rest at home, get better and get back to life as usual. However, when people are told that there's a killer virus afoot, they get sick, panic and do present to a healthcare provider and do become part of the statistics. So, by nature of the hype effect, COVID-19 artificially appears more contagious, more prevalent, etc. than the seasonal flu.

I further argue that even mortality rates are inflated by the hype factor. Someone dies today of severe flu symptoms, the test is applied and it gets chalked up to COVID-19, if indeed there is COVID_19 present, if the test is accurate, etc. With the seasonal flu, someone gets a severe case, goes to the hospital eventually and succumbs to pneumonia or other secondary conditions and it is those secondary conditions that are noted as the cause of death; not the flu.

BTW, I work in actuarial for a major healthcare insurance company. I'm not just creating my opinion from youtube videos; doesn't mean I'm 100% correct - or even 10% correct - and my observations and questions are sincere as you appear to have expertise in a similar area as well.

Deap


Sent From member of the Stanford hospital board. This is their feedback for now on Corona virus: The new Coronavirus may not show sign of infection for many days. How can one know if he/she is infected? By the time they have fever and/or cough and go to the hospital, the lung is usually 50% Fibrosis and it's too late.

Taiwan experts provide a simple self-check that we can do every morning. Take a deep breath and hold your breath for more than 10 seconds. If you complete it successfully without coughing, without discomfort, stiffness or tightness, etc., it proves there is no Fibrosis in the lungs, basically indicates no infection. In critical time, please self-check every morning in an environment with clean air.

Serious excellent advice by Japanese doctors treating COVID-19 cases: Everyone should ensure your mouth & throat are moist, never dry. Take a few sips of water every 15 minutes at least. Why? Even if the virus gets into your mouth, drinking water or other liquids will wash them down through your throat and into the stomach. Once there, your stomach acid will kill all the virus. If you don't drink enough water more regularly, the virus can enter your windpipe and into the lungs. That's very dangerous. Please send and share this with family and friends. Take care everyone and may the world recover from this Coronavirus soon.

IMPORTANT ANNOUNCEMENT - CORONAVIRUS
1. If you have a runny nose and sputum, you have a common cold
2. Coronavirus pneumonia is a dry cough with no runny nose.
3. This new virus is not heat-resistant and will be killed by a temperature of just 26/27 degrees. It hates the Sun.
4. If someone sneezes with it, it takes about 10 feet before it drops to the ground and is no longer airborne.
5. If it drops on a metal surface it will live for at least 12 hours - so if you come into contact with any metal surface - wash your hands as soon as you can with a bacterial soap.
6. On fabric it can survive for 6-12 hours. normal laundry detergent will kill it.
7. Drinking warm water is effective for all viruses. Try not to drink liquids with ice.
8. Wash your hands frequently as the virus can only live on your hands for 5-10 minutes, but - a lot can happen during that time - you can rub your eyes, pick your nose unwittingly and so on.
9. You should also gargle as a prevention. A simple solution of salt in warm water will suffice.
10. Can't emphasis enough - drink plenty of water!

THE SYMPTOMS
1. It will first infect the throat, so you'll have a sore throat lasting 3/4 days
2. The virus then blends into a nasal fluid that enters the trachea and then the lungs, causing pneumonia. This takes about 5/6 days further.
3. With the pneumonia comes high fever and difficulty in breathing.
4. The nasal congestion is not like the normal kind. You feel like you're drowning. It's imperative you then seek immediate attention

Deap

Which is scarier: (1) The corona virus; (2) people feeling they have no control over their own lives; (3) people refusing to accept they do have control over their own lives.

Serge

"They survived the coronavirus. Then they tested positive again. Why?"
https://www.latimes.com/world-nation/story/2020-03-13/china-japan-korea-coronavirus-reinfection-test-positive
For those popup averse(I am):
http://archive.is/9SMYm

Short answer: "Dunno"

Lawrence Kart

Fred -- 32 million people have died from AIDS worldwide since 1981, which is what I meant when I wrote "32 million people are missing." The American death toll was 770,000. Because Coronavirus, like AIDS, is a worldwide event, I thought my words would be understood that way.

Larry Kart

Mark Logan

I'd like to thank JJackson for his expert commentary.

I'm at the ground ero Seattle but can't add to the science of this, but will warn the rest of you that hording has become a problem and has moved beyond wipes and hand sanitizers to foodstuffs, particularly frozen foods. Be warned!

Also to be warned are those hording toilet paper: You clowns have rendered every shelf TP bare in every store in Seattle. I'm not going to address the wisdom or otherwise of this. However, know that while it's highly unlikely you will successfully out-run me while toting two hay-bales of Costco TP, dropping one of them will render the question moot.

Jack

“Can you explain to me (sincerely asked) how, for example, S. Korea was able to have ubiquitous tests for this specific virus not only developed, but also distributed within a month or two (at the most) from the first cases being reported in China?

The SoKos are either super scientists and industrialists in a super organized society, or there is some degree of BS associated with the tests.”

Eric,

The article linked below may provide an answer to your question.

How this South Korean company created coronavirus test kits in three weeks

https://www.cnn.com/2020/03/12/asia/coronavirus-south-korea-testing-intl-hnk/index.html

My speculation is that our CDC & FDA got caught in their bureaucratic turf game and didn’t allow our molecular biology companies to produce the test kits and have them shipped to our medical diagnostic lab companies with a nationwide footprint like Labcorp and Quest. I was unimpressed with CDC director Redfield during his testimony to Congress. He came across to me as the perfect bureaucrat skilled at that game and not the type of person who can think out of the box or act outside the red tape.

It appears that the public health authorities in Taiwan, HK, Singapore and South Korea didn’t want to take any chances and reacted swiftly and aggressively. Taiwan has only had 50 cases and 1 death despite the volume of traffic with China.

https://www.businessinsider.com/coronavirus-taiwan-case-study-rapid-response-containment-2020-3

Here’s wiki on testing:

https://en.m.wikipedia.org/wiki/COVID-19_testing

guidoamm

In the psychosis that is taking hold in countries around the world, there is something I do not understand.

Cruise ships carry a high density population of mostly elderly individuals, with crew and passengers living at very close quarters, in a confined space, with no possibility of sterile isolation.

This is your typical nightmare scenario for the propagation of a virus.

If this virus is so contagious and lethal, I am at a loss to explain the lack of dead on said cruise ships. In theory, by now, we should have dozens if not hundreds of dead from those ships. By my last count however, 6 elderly passengers from the Diamond Princess passed away of complications related to Covid19 and, so far, 1 former passenger from the Grand Princess has succumbed.

Few infections and, certainly, no othere fatalities have been reported from all cruise ships. In total, we are talking about some 9000 people between passengers and crew on 3 ships where Covid19 had been detected.

What am I missing?

John Lee

About China being on the downside of the infection curve... no shit - the entire country went on a war footing once Xi realized coverup was not possible and his enemies will use any failure against him. He could not afford to lose. China threw everything it had against it, including sucking in global resource stockpiles (tried to buy a N95 mask or even any PPE lately ?).

The idea that the west can match China's containment measures or even resources at this point (China not only consumed much of the global stockpiles of PPE, but also manufactures most of it! also ventilators !) to follow them down the same curve is laughable. The only option is to fight "smarter" like SKorea, Singapore or Taiwan.

Even this is unlikely as the west squandered the 1-2 months lead time it had - complacent citizens thought "it couldn't happen here" and so their governments did nothing. Once this was shattered by Italy, the panic started. Contrast this with SKorea, Singapore, Taiwan which had had prior outbreaks of SARS/MERS and so their govs did not waste time and instituted measures quickly - their citizens also did not need to be convinced/educated of the need for social distancing and hand cleanliness. This speed is what saved them. The west no longer has this luxury.

And lastly - healthcare workers dont really fear the CFR - they have dealt with worse (Ebola etc). What gives healthcare workers nightmares about Covid19 is the combination of infectiousness (infectious BEFORE symptoms - so stealth !) and 20% hospitalisation rate (from china data and now confirmed by italian doctors). No western country has enough beds for this once exponential growth gets underway ! Combine this with the lack of PPE (healthcare workers have to ration/reuse N95 masks and PPE) which over time means healthcare workers themselves become infected and have to self quarantine. Once out of beds/healthcare workers your CFR will jump. This is what naive comparisons of CFR numbers misses; CFR numbers from diamond princess and skorea only hold if all who want care get it. This is now not happening in Italy. Not to mention once beds are all filled by CoVid19 patients, no beds will be available for others who need it and so you also have increased deaths from other illnesses.

If anything, if the west treated this outbreak seriously (more fear/hysteria may have driven earlier action) from the onset, it could hope for a Taiwan/SKorea/Singapore outcome. Now ? Maybe the summer can come to the rescue and Trump may be proven right. Maybe he feels lucky ?

But as I am in Australia I have no such luxury - we are now going into winter and so our healthcare sector faces load from both covid19 and our normal flu. I hope we can cope.

JJackson

Eric
The Korean story is interesting in that most of their cases from a religious sect which was ostarcised and had a young following. The age distribution has caused a lot of 20 to 30 year old cases and the sect kept records of all its members making contact tracing in a fairly tight community a lot simpler. The PCR testing is covered in the post I have linked to several time before, and will add again below. Post #1 gives a brief description of PCR testing and in post #10 I look at it again in a little more detail in light of the problems experienced with tests in the US. One point I did not explain is why the US system decreed that the CDC should be the developer of the test when hundreds of labs could also develop a test, which is what is happening now. The problem with everyone using their own tests is the collated data is no-longer directly comparable as different test may vary in sensitivity. I have added a second link which looks at the Korean experience in more detail.
re your second post. The CAR is how many infections occur in a population divided by population size. 'Crude' in front of any epi number meaning it is based on what ever data is available at that time. So at present that is about 135k case in 7.8 billion people. Without serology testing we do not know how many more sub-clinical cases there are even if it doubles the total it still means 0.00% of us have had it. In a population with no immunity exposed to any new pathogen heard immunity will not slow spread noticeably until at least 10% of the population have antibodies. (again post #1 was written in anticipation of most of the questions in these threads).

TTG
The first link, again, this time I look at what China did in post 10. In post #11 I was asked your question by an American member and replied as best I could in post #12.

Serge
A bit of recidivism is not uncommon as the virus titers fall, during recovery, below the test sensitivity threshold and then rise a bit to a detectable level. The second possibility is reinfection prior to antibody build up (or poor antibody response). The WHO is actively trying to establish which explanation is responsible for the recurrences found.

https://flutrackers.com/forum/forum/the-pandemic-discussion-forum/jjackson-s-workshop/826486-covid-ncov-preliminary-thoughts-jjackson-personal-opinion
https://asiatimes.com/2020/03/why-are-koreas-covid-19-death-rates-so-low/

Eric Newhill

Jack,
I'm sorry, but that article doesn't inspire confidence, for me at least. I'm not trying to be difficult. I'd like to think that such a test exists, is accurate and that human ingenuity could create it so quickly.

First off, the article is CNN. Hey, maybe they got something right for once. The article goes on to say that a super computer with AI designed a test that reacts to coronavirus DNA and it did so, in three weeks, simply based on what had been released about the virus' DNA without even having a sample of virus material. That doesn't cut it for me. Call me a Luddite if you will, but I am skeptical of the power of AI. AI is only as good as the humans that programmed it. I've yet to see any that is truly independently intelligent.

Somehow, a reagent that turns a certain color when the presence of covid-19 DNA is present in a sample was also developed in the three week time frame. That, by itself is a miracle of bio-engineering if true. Lots of miracles and tech magic involved in this story. Claims of miracles and magic make me suspicious.

As I said, there are a number of flu causing coronaviruses out there (and some non-flu causing strains). I don't much, really nothing, about genetics. I do know something about how the real world tends to work - and I know how science is supposed to work. I need to see proof that the test isn't reacting to the similar DNA of other coronaviruses.

IMO, super computers and AI or not, three weeks is not enough time to understand how a test might be producing false positives and false negatives with regards to the specific virus in question; covid-19.

Deap

Corona quote of the year: I am panicking because other people are panicking. (Overheard in a Costco TP line)

Eric Newhill

JJackson,
Thanks for the links. I missed your previous posting of them. Sorry about that.

The links help a little. A lot of the information you're conveying in them is lost on me because I don't understand genetics anymore than the next guy.

Please allow me to ask you directly, given what you say in the link, do you really believe that the S. Koreans could develop - without any sample material - a drive through test that accurately (acceptable/normal industry standard level of false positives/negatives) - identifies this new virus in three weeks?

And - what about Guidoamm's question? IMO, it's a good one. How does this virus compare to other outbreaks on cruise ships in terms of severity of symptoms, mortality, how contagious it is, etc?

Deap

Sharyl Attkisson took the time to profile those to date who have died, associated with the corona virus - not just "elderly" but primarily compromised by underlying health conditions, along with advanced birthdays.

What me worry? No, not really even though I am old enough to have been raised on MAD magazines. https://sharylattkisson.com/2020/03/profile-of-u-s-coronavirus-deaths-to-date-elderly-sick/

different clue

The reasons for old people, pre-old people with certain prematurely-aged organ systems, immuno-compromised people, immuno-suppressed people, and non-old people already-with debilitating or weakening chronic disease conditions to be concerned about not contacting this virus are evident by now.

The reason for non-old non-compromised non-sick people to be concerned about not contacting this virus is so that they don't contract the virus and potentially become typhoid Mary corona-spreaders who would facilitate getting the virus to those who might sicken and die. We should all practice safe-airgapping from eachother, safe thing-touching, steady handwashing and hand-sterilizing, etc.

I work at UM hospital. Our overall employer has set up a clickable link to evolving corona virus information as the U of M understands it to be. Here is the link. ( I am assuming it works).

http://www.med.umich.edu/i/ice/resources/coronavirus.html

English Outsider

Proposed UK measures. Isolation for those over 70

https://www.itv.com/news/2020-03-14/elderly-to-be-quarantined-for-four-months-in-wartime-style-mobilisation-to-combat-coronavirus/?fbclid=IwAR3pximu0r_KVP0Um2DGz9rt5C_VkVMlCxcoA8li3PfVYa6wrcOCoQSvvxQ

Jack

Eric

As Col. Lang has educated us, we should evaluate the information independent of the source.

Here’s the bottom line. South Korea, Singapore, HK and Taiwan have minimal overall disruption to their societies and economy relative to the US and Europe. There’s a lesson learned there in swift early responses even if it may turn out to be an over-reaction in hindsight.

An important aspect in these types of situations is confidence among the public. Saying it’s just the flu, which very well could be correct and dismissing concerns of the public in this age of instant communications and social media is foolish. When people are concerned the best strategy is to address their concerns directly. It makes sense why people are concerned when they see images from Wuhan and notice the draconian actions there and news of ICUs in Lombardy being swamped.

As far as tests are concerned the US has a large cutting-edge molecular biology industry. The CDC chose not to avail that capability and instead decided to do it on their own while not doing a good job, contributing to fear that the healthcare system was not on top of things. That IMO was classic bureaucratic turf game and a strategic error. While you may question the accuracy or reliability of the South Korean tests, it’s beside the point. The bottom line is it worked to prevent large scale societal and economic disruption in Korea by instilling confidence among the public that active measures were being taken to prevent spread.

I remain sanguine although I’m in the most vulnerable age group and believe this will also blow over. However I believe these disruptions and economic impact was unnecessary and could have been easily mitigated if those entrusted to maintain public confidence in situations like this acted determinedly. Trump, IMO, should have acted the way he’s doing now a month ago. One thing this incident proves is the US is extremely vulnerable as it has shipped overseas it’s industrial capacity including pharmaceuticals. Of course nothing will likely be done as the financial elites who benefited from this continue to dominate the political system. Can we actually ever fight a war with the Chinese communists when likely critical parts of our military supply chain is right there? That vulnerability will be exploited at the most inopportune moment.

JJackson

Eric
I was not really expecting SST readers to bother with the Virology section the bit on Epidemiology and testing is readable and, if understood, nothing that has happened, or is coming, should be a surprise.
I forgot to cover flu testing which you also asked about. Developed nations all run seasonal flu sentinel system in which a geographically representative selection of GP practices do test everyone with ILI (influenza like illness - a blanket diagnosis for anyone with flu like symptoms). This allows an overview of the circulating strains and how much of the winter ILI is actually flu rather than colds etc. In addition Hospitals are testing anyone who gets a ILI critical care bed. After the flu season is over the excess deaths, over summer levels, is measured and an estimation is made, from the three data sets, of many of those deaths can be attributed to flu.
re the Korean testing it is not a problem for them to have had lots of PCR labs ready to test if they used the protocols provided by China. What I do not know is what they used for the drive-thru testing as RT PCR is not that fast and the machinery is very expensive and needs expert operation. To try and answer your Q I posted a request for information on the Flutrackers Covid discussion thread (much like this thread but it is already over 150,000 posts) asking they post here or let me know. I had a reply from a friend who has emailed the KCDC but we have not had a reply yet. What I have found is at the wiki link Jack provided.
re Jack's wiki link (which I will re post below). The first thing to note is the table at the top which shows that Italy and Korea have tested 5000 per million of their population where the US has tested 50. Further down you will find a graph show the very low number of CDC tests (blue) and then a massive jump in test per day once other labs were allowed to use their own tests. Below the first table is a smaller one showing which countries have developed their own tests, Korea is not one of them so I assume they used the tried and tested Chinese protocols. In the immunoassay section you will find this "On Feb. 28, 2020, a South Korean company called PCL filed a request to Ministry of Food and Drug Safety of South Korea for their antibody-based detection kit, COVID-19 Ag GICA Rapid. Unlike an RT-PCR-based detection kit, PCL claims that their antibody-based kit could make a diagnosis within 10 min. ". It does not state that is what was used but would be my best guess

re guidoamm's Q on cruise ships I have linked below a MedRXIV paper looking at this and this is a comment I made.
"Fortunately for the passengers and crew, but unfortunately for calculating the CAR, the index case was identified before the 2nd generation cases showed. This allowed testing and quarantine/social distancing which will have protected many passengers from exposure which in turn will make their 17% estimate low. It does however show that this figure is more than achievable in the world at large. Pick what ever CFR you like and apply it to 17% of your population and that is how many dead you will have. The CAR could be twice this or more. How you manage to spread those deaths over time will determine if your CFR remains a constant, if you exceed your ICU/mechanical ventilator surge limit you must expect every case there was not room for to die - ICU triage by that point is not going to give space to anyone it is unlikely to save or who had a fighting chance without it. In a badly managed wave peak your x ICU beds may have 10x or more patients who meet admission criteria."
The usual problem on cruise ships is Norovirus which is highly contagious and, while very unpleasant, is not a major killer. The CDC shows 70,000 hospitalisations a year with 800 deaths.

https://en.m.wikipedia.org/wiki/COVID-19_testing
https://www.medrxiv.org/content/10.1101/2020.03.05.20031773v2

JJackson

One more link. This time to another FluTracker member who also runs a blog and writes beautifully clear posts. He has been at it for a while and this is his blog post #15,094 entitled Ventilator Shortages And Pandemic Triage.
https://flutrackers.com/forum/forum/internet-communication/avian-flu-diary/836916-ventilator-shortages-and-pandemic-triage

Deap

Translation: "Flatten the Curve" - voted new buzz words of the year

Spread the threat of the fairly behign "corona" infections long enough to influence Nov 2020 elections.

"Social distanciing" now means shutting everything down to "flatten the curve" of the normal life-cycle of a any typical flu season viral infection, when people pass it around and it gradually mutates and weakens into a non-event..

Bummer, if left to its normal life cycle it would be over in another month or so. Not good enough says the deep state and the Democrats. We need to milk this puppy right up to election day. Make it last until November - "flatten the curve" of its normal distribution and duration.

So close everything down, bring everything to a half force people to b chained only to online news sources at home with no public discussion. Control and capture their hearts and minds and get this cretin Biden elected so we can get our hands back on the public check book.

A twofer - destroy the economy at the same time and blame Trump.

different clue

Blogger Ian Welsh has written a post called " Taking The Coronvirus Seriously". I feel confident that "coronvirus" was just a typo on his part and he was thinking " coronavirus".

Be that as it may, I consider him a serious good-quality layman thinker whose posts are usually worth reading and thinking about.
Almost all this post is about the meaning of coronavirus itself and how we approach it, especially individually unless and until the collective approach becomes sufficient to the level of the problem.

In this post he discusses " flattening the curve" and how failing to do that led to the spike of deaths in North Italy and how successfully doing that keeps the number of dangerous cases per unit timespan at or under the capacity of hospitals to treat those cases. Treatment can often save lives which would be lost from lack of treatment which would be imposed by more people needing treatment per unit time than available treatment capacity per same unit time.

Paragraphs two and three ( the second and third paragraphs) are critical of the TrumpAdmin's approach as of the writing of this post. Anyone who doesn't wanna hear it can give it a miss by simply scrolling past paragraphs number two and three without looking at them. The rest of the paragraphs are apolitically focused on viral affairs and personal-social approaches.

Here is the link.

https://www.ianwelsh.net/taking-the-coronvarius-seriously/

Walrus

Australia and New Zealand now require 14 day quarantine for all arrivals.

Walrus

State of Emergency just declared in Victoria, Australia. Expect all other states to do the same today. It extends Government powers during the Coronavirus pandemic.

Lawrence Kart

D - That "Stanford" list is a hoax, full of false information. The linked-to article below is one of many pushbacks:

https://www.independent.co.uk/life-style/gadgets-and-tech/news/coronavirus-symptoms-stanford-tips-protection-pandemic-advice-a9399621.html

Who the heck, and why, would anybody perpetrate such a thing?

Deap

Lawrence,

Recognize the hoax charge about that Stanford list -its immediate appeal was emphasizing how the microbes enter the body - being a respiratory infection and highlighting the importance of the hand to mouth (nose and eyes) to one's own throat.

That seems to be the missing link in most statements about this corona (or any other flu or cold) URI risk factor - the self-inoculation aspects from one's own fingers to one's own body.

Emphasizing hand washing and "hand sanitizers" without the deliberate consciousness of what one touches with those temporarily clean hands is the weakest link of all. For those reasons, I admit I jumped too early when I passed this "hoax" material on.

But I stand by this one aspect of its message, and reject along with you some of the other more hokey claims. Sufficiently chagrined, but continue to take up the charge about other ritual but ultimately meaningless prevention tasks too.

For example: After filling my car with gas today, i monitored how many surfaces I touched after touching the public gas station surfaces. Once home, I then went back and cloroxed all those touched surfaces - there were so many of them.

Car interior, garage knobs, door keys, home door handles and the cupboard cabinets touched to make up the bleach solution. Over looking any one of them, and then touching one's mouth, nose or eyes, with any lingering public gas station contamination left on them is a reminder we just don't stop thinking about this once we "wash our hands" or slather on hand sanitizer.

Instead we all need to keep far more emphasis on what we do with our hands - 24/7 - and decontaminate as well as keep our GD little fingers away from our faces. So I confess, I thought that aspect was one of the lessons from this "hoax" article that I did pass on.

As i type now from my impeccably clean keyboard. Wondering if my state governor is serious about home-quarantining all of us over age 65. Every governor wants their time in the spot light too - our-preening their colleagues.

Plus suspecting my state governor may well want to offer his services as the brokered Biden back-up come DNC 2020.

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