Coronavirus

[cherdano]

What's the current opinion on masks ? I heard many doctors in the early days of the virus saying they weren't effective.

Masks (even very simple ones - say wrap a t-shirt around your neck and make it cover your mouth) are quite effective at protecting others when you are infected. They are also mildly helpful at preventing you from getting infected.

 

Obviously you shouldn't go out buying hundreds of masks if they are in short supply for medical staff in your area. But they are helpful. https://www.washingtonpost.com/outlook/2020/03/28/masks-all-coronavirus/

 

The WHO is still advising against it - as far as I can tell they are just bonkers. Consequences will be particularly dire in the developing world where countries could easily ramp up the (cheap) production of masks but can't easily double their ventilator stock in a few weeks.

[Cyberyeti]

Masks (even very simple ones - say wrap a t-shirt around your neck and make it cover your mouth) are quite effective at protecting others when you are infected. They are also mildly helpful at preventing you from getting infected.

 

Obviously you shouldn't go out buying hundreds of masks if they are in short supply for medical staff in your area. But they are helpful. https://www.washingtonpost.com/outlook/2020/03/28/masks-all-coronavirus/

 

The WHO is still advising against it - as far as I can tell they are just bonkers. Consequences will be particularly dire in the developing world where countries could easily ramp up the (cheap) production of masks but can't easily double their ventilator stock in a few weeks.

 

The theory was that the infectious droplets were VERY fine, and if a mask was fine enough mesh to stop them, then when you breathed out, you would force it off your face and your breath would go round it rather than through it.

[Winstonm]

Masks (even very simple ones - say wrap a t-shirt around your neck and make it cover your mouth) are quite effective at protecting others when you are infected. They are also mildly helpful at preventing you from getting infected.

 

Obviously you shouldn't go out buying hundreds of masks if they are in short supply for medical staff in your area. But they are helpful. https://www.washingtonpost.com/outlook/2020/03/28/masks-all-coronavirus/

 

The WHO is still advising against it - as far as I can tell they are just bonkers. Consequences will be particularly dire in the developing world where countries could easily ramp up the (cheap) production of masks but can't easily double their ventilator stock in a few weeks.

 

Depends on the size of the virus.

[FelicityR]

Masks are quite effective at stopping infected individuals from spreading the virus

Masks are somewhat effective at stopping people from contracting the virus

The material that masks are made from matters enormously (linen and silk are much better than loose cotton)

 

Wear a mask, an N95 mask preferably and a scarf over it. Or alternatively a dust mask with a basic N95 medical mask inside. Doubling up your facial protection just makes sense given the current environment. The general public should be reasonably protected if they do this, practice social distancing, and keep washing their hands regularly, especially after coming indoors from outside.

 

Too many health professionals, including over 50 doctors in Italy (I read yesterday) have died, and whilst they are on the frontline of treating this illness, it just shows how easily the virus is transmitted, despite many of the health professionals having the right equipment to shield themselves from the virus. And yes, I have also read about a lack of basic equipment in some hospitals, too.

[pescetom]

Today's statistics in Italy: positive 73880 (+5.5%), dead 10779 (+8%), no longer infected 13030 (+5%). Intensive care 3906 (+1%). Fatality rate 12.7%.

The reported positive rate remains steady and well above the rate of intensive care, despite the fatality rate nudging ever higher.

 

Thinking about differences of Italy vs UK, I suspect the most important ones are cultural and sociological. The risk of serious civil disorder is stronger in Italy, particularly in the south where much of the economy is illegal and the balance of power between the state and the mafia is delicate even in normal times. More in general, Italians tend to put their family before almost anything else, as sociologists have discussed for decades.

[Winstonm]

Social distance, social distance, social distance.

 

We found that the stability of SARS-CoV-2 was similar to that of SARS-CoV-1 under the experimental circumstances tested. This indicates that differences in the epidemiologic characteristics of these viruses probably arise from other factors, including high viral loads in the upper respiratory tract and the potential for persons infected with SARS-CoV-2 to shed and transmit the virus while asymptomatic.3,4 Our results indicate that aerosol and fomite transmission of SARS-CoV-2 is plausible, since the virus can remain viable and infectious in aerosols for hours and on surfaces up to days (depending on the inoculum shed). These findings echo those with SARS-CoV-1, in which these forms of transmission were associated with nosocomial spread and super-spreading events,5 and they provide information for pandemic mitigation efforts.

https://www.nejm.org/doi/full/10.1056/NEJMc2004973

[y66]

From the Financial Times:

 

The urgent demand [for ventilators] has, however, sparked a wave of ingenuity. An Italian 3D printing start-up has converted a snorkelling mask for use with hospital ventilators, while a project involving Mercedes, Formula One and London university engineers has developed a breathing aid for use in intensive care that frees up ventilators for the most severely ill patients.

 

Sifted, our site for tech start-ups, reports on the frenetic hackathons and crowdsourcing efforts to fill the gap, including a project making a ventilator from windscreen wiper motors.

[pescetom]

Today's statistics in Italy: positive 75528 (+2%), dead 11591 (+8%), no longer infected 14620 (+12%). Intensive care 3981 (+2%). Fatality rate 13.3%.

So an apparent (we will see) second drop in the positive rate, but not in the death rate.

 

It would be interesting to know the truth about how many died in Wuhan and even more so about how many were infected but survived.

Articles like this are suggesting 40K+ deaths of which at least 25K+ attributable to Covid19.

It would be doubly sad if they all died without even establishing herd immunity, as these numbers seem to imply.

[y66]

Time magazine has some interesting country comparisons based on data compiled at Johns Hopkins.

[mythdoc]

Today's statistics in Italy: positive 75528 (+2%), dead 11591 (+8%), no longer infected 14620 (+12%). Intensive care 3981 (+2%). Fatality rate 13.3%.

So an apparent (we will see) second drop in the positive rate, but not in the death rate.

 

It would be interesting to know the truth about how many died in Wuhan and even more so about how many were infected but survived.

Articles like this are suggesting 40K+ deaths of which at least 25K+ attributable to Covid19.

It would be doubly sad if they all died without even establishing herd immunity, as these numbers seem to imply.

 

The numbers are underreported in many countries by a large magnitude. The US numbers are a joke, and this thing is just ramping up.

[FelicityR]

I don't believe that 'political point scoring' by comparing one country's covid-19 statistics with another will actually help anyone. We all know that Italy's and Spain's statistics are as honest as can be (sadly); and the UK's are honest but potentially flawed as until recently there was not widespread testing in this country.

 

As Winstonm said, social distancing seems the best way to contain the spread of the contagion. And widespread testing proves extra security. Here in the UK, it seems (and this is a very early indication) that the lockdown measures introduced just over a week ago, with the emphasis on social distancing are having some effect: a smaller percentage number tested positive for covid-19, and a smaller percentage have died, though that is only for the last three days. But that can change...

 

What annoys me more is world leaders ignoring the fact that this is a serious pandemic and trying to sweep it under the carpet. The Belarus president has reportedly said vodka and saunas will stop you getting coronavirus, and the Brazilian president is also in denial. Please wake up!

 

The British and American responses to covid-19 may have not been perfect, but at least both administrations are taking this seriously now. But, at the end of the day, it's up to the people in the country ultimately to take responsibility from the guidance they have been issued by their respective governments.

[johnu]

As Winstonm said, social distancing seems the best way to contain the spread of the contagion. And widespread testing proves extra security.

US testing is far behind most other industrialized countries on a per thousand basis. In almost every section of the country, tests are strictly rationed. So much for extra security :( With 330 million people, it will be months if not years before we have the capacity to test everybody.

 

 

The British and American responses to covid-19 may have not been perfect, but at least both administrations are taking this seriously now. But, at the end of the day, it's up to the people in the country ultimately to take responsibility from the guidance they have been issued by their respective governments.

The US response is still very mixed awful.

 

The Grifter in Chief has consistently downplayed the seriousness of the effects of the virus, and played up how early the country can get back to normal. This had led to a large gap in the percentage of Democrats and the percentage of Republicans who believe the situation is about to be catastrophic. Fox Propaganda and other right fringe media has been downplaying the seriousness of the situation for months, and if people are misled into thinking COVID-19 isn't that big a deal, they aren't going to protect themselves as well as they should, and by extension, endangering everybody else.

 

There is no national shelter in place order, and almost 20 states, most in the mountain, central and southern states which have Republican governors do not have statewide orders. The Republican governor of Mississippi issued an executive order which basically classified almost all businesses as essential and not subject to mandatory closure. And Florida, which has an extensive senior population, is on the verge a huge spike in cases and still doesn't have a statewide shelter in place order. If these areas of the country that currently have few cases don't do everything they can to "flatten the curve", the entire country could be inundated with critical care cases that swamps the medical system.

 

The distribution of personal protection equipment and ventilators is becoming more chaotic by the day without Federal oversight of the distribution systems. Hospitals are bidding for scarce equipment against other hospitals, states are competing with other states, and states are competing against the federal government. Somebody has to be in overall charge to determine which areas have immediate needs and which areas can wait a little longer. And the Defense Production Act wasn't used for the past 2 months and is still only being applied to 1 ventilator contract (and apparently wasn't actually needed as the 2 companies had already reached a contract).

[FelicityR]

The US response is still very mixed awful.

 

Thank you, John, for detailing at length the US response. From what I am reading on this side of the Atlantic, I agree, too, that the US response has been less than satisfactory. And Donald Trump's comments and (lack of) actions were truly unhelpful.

 

And yes, having the resources to test the whole of the American population is a logistical nightmare.

 

Whilst I do not support Boris Johnson and the Conservative Party, I have to say that their response in the latter stages has been excellent, and the spirit of the British people has shone through, many volunteering to distribute grocery supplies or help the National Health Service. And the doctors and nurses tirelessly working within the NHS have been magnificent.

[Cyberyeti]

The numbers are going to be fairly meaningless. Data from Iceland (where they've done a lot of testing relative to the population size) suggests that half the cases are asymptomatic and a lot more have very mild symptoms.

 

Until mass runs of the antibody test are done, we won't know how many people have already had it.

 

One source https://english.alarabiya.net/en/features/2020/03/25/Coronavirus-Iceland-s-mass-testing-finds-half-of-carriers-show-no-symptoms

[y66]

From Sam Jones at FT:

 

Austria is to join a small but growing number of European countries making the wearing of face masks outside the home compulsory amid shifting debate over the medical gear’s protective utility.

 

Authorities would start distributing millions of free face masks at the entrances to all supermarkets from midweek onwards, chancellor Sebastian Kurz announced on Monday. Shoppers will only be permitted inside supermarkets and other open stores, such as pharmacies, if they are wearing masks.

 

While masks are a familiar sight throughout Asia, the only other countries in Europe to require the wearing of masks in public space are Slovakia, the Czech Republic and Bosnia-Herzegovina.

 

The step would be a “learning phase” for further measures to come that would mandate the use of masks for any situation outside the home likely to bring people close to one another, Mr Kurz said on Monday.

 

“I’m fully aware that wearing masks is something alien to our culture,” he added. “Together we have to do everything [possible] so that we can quickly return to normalcy and a functioning economy.”

 

The move by Vienna comes as European governments devise ways to contain the spread of Covid-19 and keep it from re-emerging after their economies come out of their prolonged self-imposed lockdowns. It marks a departure from earlier official guidance.

 

The WHO and many governments say healthy people do not need to wear a mask unless they are taking care of a person with suspected Covid-19 infection. The advice is partly an attempt to stop people who don’t need masks — which are in short supply in many places and needed by health workers — from trying to buy them.

 

The German government may enforce a similar obligation when it considers relaxing the lockdown measures, health ministry spokesman Hanno Kautz said on Monday, according to Reuters. Such masks could help protect others from contracting the illness from the wearer, Mr Kautz was quoted as saying.

 

France initially advised its citizens not to wear masks, then advised they should wear one only if they were infected or if they worked in care or retail. The main reason was that the government chose to keep its short supplies for hospitals.

 

But French trade unions representing shop assistants, factory workers and police officers have demanded safety equipment for all staff or else they would exercise their right to refuse to work in dangerous conditions.

 

In Italy, where the outbreak has been the deadliest in the world, the wearing has within a month gone from attracting disapproving looks to being socially obligatory.

 

The free masks delivered by the Austrian government will not meet the same medical standards as those used on the front line by doctors and nurses, but Vienna hopes that by forcing citizens to cover their noses and mouths in public, even if with simple barriers, will have a meaningful impact on transmission of the virus.

 

Advice from the Austrian government’s medical advisers indicates the new coronavirus is likeliest to be spread through larger droplets ejected by coughing and sneezing — which a rudimentary mask might impede — rather than in smaller aerosol particles that the body sheds through breathing alone that could only be stopped by more sophisticated means. The Red Cross has issued guidance in Austria to citizens on how they can make their own masks at home.

 

“It would be a mistake to think that such masks protect you,” Mr Kurz added. “But the airborne transmission is somewhat reduced. This is not a substitute for [social] distancing.”

 

Austria’s has been among the most aggressive governments in Europe in taking action to curb public life in order to stop the pandemic: the approach — which has even included sequestering tourists in hotels in designated quarantine zones such as Tyrol — has yielded Mr Kurz’s government plaudits at home. It stands in contrast to the more laissez-faire approach adopted in the UK and Sweden.

 

Police in Austria have rigorously enforced stay-at-home rules and movement restrictions: according to the interior ministry, more than 10,426 cautions have been given.

 

The government has said it will not even consider the rollback of restrictions until the daily growth rate of new coronavirus cases falls below 1 per cent. As of Monday morning, Austria had recorded 8,813 confirmed Covid-19 cases — with 108 deaths. The growth rate has decreased over the past two weeks, from roughly 40 per cent in mid-March, to 11 per cent.

 

“The truth is, it’s a marathon and it’s not our job to just say what you want to hear,” Mr Kurz said.

[pescetom]

Today's statistics in Italy: positive 77635 (+3%), dead 12428 (+7%), no longer infected 15729 (+8%). Intensive care 4023 (+1%). Fatality rate 13.8%.

Looks like a confirmation of a second and lower plateau for he positive rate, but the fatality rate continues inexorably to rise.

Who knows how many are really positive, or even healed.

The Veneto region has begun random testing for antibodies, something which must have been done in China and should be public domain.

[FelicityR]

Today's statistics in Italy: positive 77635 (+3%), dead 12428 (+7%), no longer infected 15729 (+8%). Intensive care 4023 (+1%). Fatality rate 13.8%.

Looks like a confirmation of a second and lower plateau for he positive rate, but the fatality rate continues inexorably to rise.

Who knows how many are really positive, or even healed.

The Veneto region has begun random testing for antibodies, something which must have been done in China and should be public domain.

 

The positive rate in the UK remains at 14%, with over 25,000 positive now, but yesterday we had a huge spike in the number of deaths (+27%) with 381 people sadly succumbing to this illness. 1,781 have now died. Perhaps, in two weeks time, we will finally know whether the lockdown in the UK, and the strict social distancing and non-socialising measures in place have been effective. Our Prime Minster, Boris Johnson, warned yesterday the coronavirus epidemic will 'get worse before it will get better'. It's a grim prediction, but I believe it is better to be honest.

 

Here in the UK, the military have been instrumental in constructing the field hospitals very quickly that will take newer coronavirus cases. Already there's a remit that the worst cases, and those more at risk, will be treated in existing National Health Service hospitals, and that the less severe will be treated in the field hospitals.

[Cyberyeti]

The positive rate in the UK remains at 14%, with over 25,000 positive now, but yesterday we had a huge spike in the number of deaths (+27%) with 381 people sadly succumbing to this illness. 1,781 have now died. Perhaps, in two weeks time, we will finally know whether the lockdown in the UK, and the strict social distancing and non-socialising measures in place have been effective. Our Prime Minster, Boris Johnson, warned yesterday the coronavirus epidemic will 'get worse before it will get better'. It's a grim prediction, but I believe it is better to be honest.

 

Here in the UK, the military have been instrumental in constructing the field hospitals very quickly that will take newer coronavirus cases. Already there's a remit that the worst cases, and those more at risk, will be treated in existing National Health Service hospitals, and that the less severe will be treated in the field hospitals.

 

Strange fact that nobody's satisfactorily explained but has been brought up several times. (In the UK) there seems to be a big spike on a Tuesday (reporting Monday's deaths) because the numbers flatten over the weekend so make it look bigger.

[PassedOut]

The numbers are going to be fairly meaningless. Data from Iceland (where they've done a lot of testing relative to the population size) suggests that half the cases are asymptomatic and a lot more have very mild symptoms.

 

Until mass runs of the antibody test are done, we won't know how many people have already had it.

 

One source https://english.alarabiya.net/en/features/2020/03/25/Coronavirus-Iceland-s-mass-testing-finds-half-of-carriers-show-no-symptoms

The whole testing situation in the US concerns me a lot. In mid-February I spent some time in San Jose, California visiting my youngest son, who works at a nearby tech company. Because of the virus there, lots of folks were wearing masks, and I did too, but not on the plane flights to and from San Jose. Later I learned that some of the TSA crew at the San Jose airport tested positive and that whole crew was sent home. On March 1, my youngest son flew from San Jose to work remotely from Constance's and my home. The next day he developed a fever and a cough, but the fever only lasted a few hours and he felt quite a bit better after a few days.

 

On March 9, I started coughing (no fever) and saw my doctor. Because I am in my 70s, have had asthma all my life, and need my blood pressure controlled, my doctor placed me in a high-risk group for the virus. With the lack of fever, though, both she and I considered it unlikely that I had the virus -- but she thought it a good idea for me to be tested anyway. I waited around for her to make the arrangements, but she found that I did not qualify for one of the (very scarce) tests because I didn't have a fever.

 

She made another call to a government official that we both know, who said that if I really wanted to be tested, he could make that happen. He and my doctor left the decision to me. I declined, not wanting use up a scarce test that I didn't really qualify for.

 

Right now eight family members live with us at our place, some working remotely. We're having everything delivered, only going out for walks (and avoiding other people then), washing hands incessantly, etc. Everyone here seems healthy, but I'm very aware now that it's possible that we might have had the virus and passed it on to others in early March. And I still don't know for sure! Argh.

[FelicityR]

With the lack of fever, though, both she and I considered it unlikely that I had the virus...

 

I was reading an article this morning about Chinese coronavirus cases, and quite a few people test positive but display virtually no symptoms, thus being asymptomatic. As I said in a previous post, I am still convinced there's some other factor other than age and (ill) health - though these are the primary ones - that result in either an asymptomatic or a severe reaction to the virus. Until the medical world discover what mechanism makes covid-19 so deadly for some, or just mild for others, we should all keep safe until this pandemic is finally over.

[Winstonm]

There may be a hint of some better news about the virus as reported this a.m. in the New York Times:

 

By Denise Grady

April 1, 2020

Updated 1:20 p.m. ET

 

 

The malaria drug hydroxychloroquine helped to speed the recovery of a small number of patients who were mildly ill from the coronavirus, doctors in China reported this week.

 

Cough, fever and pneumonia went away faster, and the disease seemed less likely to turn severe in people who received hydroxychloroquine than in a comparison group not given the drug. The authors of the report said that the medication was promising, but that more research was needed to clarify how it might work in treating coronavirus disease and to determine the best way to use it.

 

“It’s going to send a ripple of excitement out through the treating community,” said Dr. William Schaffner, an infectious disease expert at Vanderbilt University.

 

The study was small and limited to patients who were mildly or moderately ill, not severe cases. Like many reports about the coronavirus, it was posted at medRxiv, an online server for medical articles, before undergoing peer review by other researchers.

 

But please note the date - it would be a very sick joke.

[Winstonm]

This is not encouraging.

 

A new report from the Centers for Disease Control and Prevention on Wednesday provides new evidence to bolster early reports that the transmission of the coronavirus — which has now infected over 887,000 people worldwide — can happen prior to symptoms. Published in the CDC’s Morbidity and Mortality Weekly Report (MMWR), the study underscores the potential difficulty of containing a virus that may be spreading silently.

[FelicityR]

This is what I put in a previous post, Winston. Possibly, and this is only a theory, people who have travelled and had vaccines for other illnesses like dengue fever, malaria, yellow fever, etc. have some advantage of fighting this illness than people who haven't. The reason I say this is that I now know of one person (a friend) who has had coronavirus, but only very mild symptoms, after returning from Asia. He is over 60, not 100% healthy, but he has travelled the world extensively, especially in Asia.

 

Hydroxychloroquine is a malaria tablet. Whether Hydroxychloroquine would work wholesale is open to question, because malaria is neither a viral or bacterial disease: malaria is caused by a tiny parasite. Donald Trump previously hyped (hydroxy)chloroquine as a game-changer.

 

However, hydroxychloroquine is also used for the treatment of rheumatoid arthritis as a disease modifying drug, where it supresses the immune system. Having a strong immune system, not one that has been compromised by ill-health, old age, or supressed by medication, is essential to fight any bacterial or viral illness, including covid-19.

[pescetom]

Yesterday's statistics in Italy (could not access the forum): positive 80572 (+3%), dead 13155 (+6%), no longer infected 16857 (+7%). Intensive care 4035 (+0%). Fatality rate 14.0%.

More confirmation of a second and lower plateau for he positive rate, but the fatality rate continues to rise.

 

Debate in Italy yesterday focussed on under-reporting of Covid19 deaths.

Bergamo University and the local paper published a study counting 4500 deaths due to Covid19 instead of the 2050 indicated by the Health Ministry.

The Mayor of Urbino (a university city in the hills of Pesaro) said they usually had 20 deaths in March but this year 150, of which 30 ascribed to Covid19.

Deaths in homes for the elderly and deaths of people in their own homes (who have never been tested) are not being counted.

So we have under-reporting by factors of 2.2 and 4.3 respectively.

Say we choose 3, that would mean 40K real Covid19 deaths so far.

Assume a true mortality rate of say 2%, that would mean 2 million people infected so far (3% of population).

Just playing with numbers, but probably less so that the official statistics even in this relatively honest country.

[y66]

However, hydroxychloroquine is also used for the treatment of rheumatoid arthritis as a disease modifying drug, where it supresses the immune system. Having a strong immune system, not one that has been compromised by ill-health, old age, or supressed by medication, is essential to fight any bacterial or viral illness, including covid-19.

I suspect you know well that some covid-19 fatalities are caused by immune systems that don't know when to turn themselves off and that some medical professionals recommend that "all patients with severe COVID-19 should be screened for hyperinflammation using laboratory trends (eg, increasing ferritin, decreasing platelet counts, or erythrocyte sedimentation rate) and the HScore11 (table) to identify the subgroup of patients for whom immunosuppression could improve mortality" per https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30628-0/fulltext

 

Edit: fixed link sorry