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Post by matt@IAA on Mar 18, 2020 21:20:41 GMT -6
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Post by ragan on Mar 18, 2020 22:35:15 GMT -6
Love seeing this. Isn't it just 20 patients virologically cured though or is there another related study with 20 more? I kinda skimmed (finals week) but it looked like 26 got the hydroxychloroquine treatment and 6 of them didn't finish it due to either being transferred into ICU, stopping treatment by choice or (in one case) dying. Either way, this sounds really promising. Go science, go! |
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Post by matt@IAA on Mar 19, 2020 15:15:11 GMT -6
I read that another study replicated it and a doc on my university forum said people are using it off-label with success.
It's not yet a "cure" as one doc said:
But still, these people are so, so smart.
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Post by ragan on Mar 19, 2020 15:29:58 GMT -6
I read that another study replicated it and a doc on my university forum said people are using it off-label with success. It's not yet a "cure" as one doc said: But still, these people are so, so smart. I know a lot of docs and a few researchers. I have every faith in them. As far as I can tell, the only job of government and the rest of us right now is to give them the resources they need and do what they tell us to. Another doc died here in Seattle yesterday. These people are as dedicated as it gets. |
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Post by ragan on Mar 19, 2020 15:34:12 GMT -6
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Post by EmRR on Mar 20, 2020 7:41:17 GMT -6
Heard from Dr neighbor here that residents are splitting into A/B teams and alternating 1 week shifts with self isolation for those off shift. We’ll see how long that lasts. First ambulatory clinic cases here yesterday.
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Post by dmo on Mar 20, 2020 10:58:31 GMT -6
After spending 6 of 12 hours per shift in tent and PPE screening potential COVID presentations the last few days I'm off and taking today as a recovery day. Enjoying my morning coffee and catching up on the forum - then going to get a guitar out and play for a bit. stay healthy out there!!
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Post by matt@IAA on Mar 20, 2020 11:13:17 GMT -6
dmo thanks for your work man keep it up and be safe
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Post by matt@IAA on Mar 20, 2020 11:15:06 GMT -6
Interesting study in the journal Science. science.sciencemag.org/content/early/2020/03/13/science.abb322186% cases are undetected. This could mean completely asymptomatic, subclinical, or just so mild people don't care to see the doctor. Or people not wanting to be welded into their homes in Wuhan. Now the question is -- is that 86% evenly distributed across all age brackets? Or is it the same as the severity distribution? |
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Post by matt@IAA on Mar 20, 2020 11:16:11 GMT -6
Good article from Peter Zeihan, a geopolitical analyst I rather like. //// Coronavirus manages to play into our weaknesses in a big way. Our brains are bad at comprehending risk, understanding probability, anticipating and accepting big changes, or dealing with uncertainty. So if this crisis has hit you like a ton of bricks, you’re not alone. And don’t worry, those spring breakers in Miami? They’ll have their own…moment. I’m sure you’ve guessed from our company name – Zeihan on Geopolitics – that we are not doctors. But making the world a bit more comprehensible is what we do, so we have turned our efforts to compiling the best information that we could find to help you understand the virus and protect yourself. I assure you this is purely selfish. If you all get sick, who will read our stuff? There are three reasons you should stay home and try your damndest not to get coronavirus. The first is that we do not know enough about the virus. Yes, it’s been around for 3+ months, but in part because of the Chinese attitude towards information control and in part because of the nature of viral medicine our understanding is limited. We don’t know if there are long-term consequences to infection for those that recover, but there are indications coronavirus can leave patients with permanent lung damage. There could be other permanent damage. We won’t know until we have people who have survived it get fully checked out months after their recovery. That will take, well, months. Second, you need to protect yourself and your family. Yes, about half of cases are so mild that they’re mistaken for a mild cold. But “mild” in the medical lexicon means something else: that you simply don’t need to go to the hospital. Another roughly 30% of the cases are that flavor of “mild”: people who experience the worst flu-like symptoms of their life. The next level up, “severe” affects an estimated 15% of cases. These people end up in the hospital because they require supportive oxygen treatment and are hardly able to use the bathroom on their own. Are most of these “severe” cases older and/or suffering from pre-existing conditions like asthma? Absolutely. Are they all? Absolutely not. Finally, about 5% of sufferers experience “critical” symptoms. They need a ventilator to breathe. That’s the fancy way of saying they need to be on life support. The largest study – one out of China – indicates half the people in this category didn’t make it (although keep in mind that it appears roughly half of all cases are so mild that they were never diagnosed with coronavirus in the first place, so it’s believed the true fatality rate is far closer to 1% of all cases than 2.5%... as long as hospitals are functioning). Which brings us to the final reason you should take this seriously. Regardless of the country you consider, no hospital has enough ventilators. America has more critical care beds than anyone else (almost more than everyone else) and we only have 100,000. Those who recover successfully from the “critical” category need a week or so of intensive care. That means if everyone lines up and gets sick in a very orderly process, and no one anywhere has a heart attack or stroke or gets in a car accident or gets stabbed or shot or otherwise needs critical care, it’ll take nearly three years to cycle through everyone who coronavirus puts into ICU. Even then, this pie-in-the-sky scenario only gives everyone precisely one week of treatment. For many that simply isn’t enough. But with hospitals overloaded, no one will be allowed to linger in those critical care beds. We have a word for what happens when you have to choose who gets help. Who to save. Triage. The Italians and Iranians have been mournfully struggling with that for days. They now have guidelines for who gets any time in critical care and who is left to die. In the worst-case scenario, four times as many Americans will die than during the whole of World War II, including the lives of doctors and nurses risking their lives for you and everyone you love. You can literally save lives by staying home and binging Netflix. So do it. Now.  Link to full size pdf mcusercontent.com/de2bc41f8324e6955ef65e0c9/files/5860f4a6-8b00-40e6-90a6-3574a8af0a95/PZ_COVID_19_Infographic_1_.pdf |
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Post by ragan on Mar 20, 2020 13:05:15 GMT -6
Good article from Peter Zeihan, a geopolitical analyst I rather like. //// Coronavirus manages to play into our weaknesses in a big way. Our brains are bad at comprehending risk, understanding probability, anticipating and accepting big changes, or dealing with uncertainty. So if this crisis has hit you like a ton of bricks, you’re not alone. And don’t worry, those spring breakers in Miami? They’ll have their own…moment. I’m sure you’ve guessed from our company name – Zeihan on Geopolitics – that we are not doctors. But making the world a bit more comprehensible is what we do, so we have turned our efforts to compiling the best information that we could find to help you understand the virus and protect yourself. I assure you this is purely selfish. If you all get sick, who will read our stuff? There are three reasons you should stay home and try your damndest not to get coronavirus. The first is that we do not know enough about the virus. Yes, it’s been around for 3+ months, but in part because of the Chinese attitude towards information control and in part because of the nature of viral medicine our understanding is limited. We don’t know if there are long-term consequences to infection for those that recover, but there are indications coronavirus can leave patients with permanent lung damage. There could be other permanent damage. We won’t know until we have people who have survived it get fully checked out months after their recovery. That will take, well, months. Second, you need to protect yourself and your family. Yes, about half of cases are so mild that they’re mistaken for a mild cold. But “mild” in the medical lexicon means something else: that you simply don’t need to go to the hospital. Another roughly 30% of the cases are that flavor of “mild”: people who experience the worst flu-like symptoms of their life. The next level up, “severe” affects an estimated 15% of cases. These people end up in the hospital because they require supportive oxygen treatment and are hardly able to use the bathroom on their own. Are most of these “severe” cases older and/or suffering from pre-existing conditions like asthma? Absolutely. Are they all? Absolutely not. Finally, about 5% of sufferers experience “critical” symptoms. They need a ventilator to breathe. That’s the fancy way of saying they need to be on life support. The largest study – one out of China – indicates half the people in this category didn’t make it (although keep in mind that it appears roughly half of all cases are so mild that they were never diagnosed with coronavirus in the first place, so it’s believed the true fatality rate is far closer to 1% of all cases than 2.5%... as long as hospitals are functioning). Which brings us to the final reason you should take this seriously. Regardless of the country you consider, no hospital has enough ventilators. America has more critical care beds than anyone else (almost more than everyone else) and we only have 100,000. Those who recover successfully from the “critical” category need a week or so of intensive care. That means if everyone lines up and gets sick in a very orderly process, and no one anywhere has a heart attack or stroke or gets in a car accident or gets stabbed or shot or otherwise needs critical care, it’ll take nearly three years to cycle through everyone who coronavirus puts into ICU. Even then, this pie-in-the-sky scenario only gives everyone precisely one week of treatment. For many that simply isn’t enough. But with hospitals overloaded, no one will be allowed to linger in those critical care beds. We have a word for what happens when you have to choose who gets help. Who to save. Triage. The Italians and Iranians have been mournfully struggling with that for days. They now have guidelines for who gets any time in critical care and who is left to die. In the worst-case scenario, four times as many Americans will die than during the whole of World War II, including the lives of doctors and nurses risking their lives for you and everyone you love. You can literally save lives by staying home and binging Netflix. So do it. Now. Link to full size pdf mcusercontent.com/de2bc41f8324e6955ef65e0c9/files/5860f4a6-8b00-40e6-90a6-3574a8af0a95/PZ_COVID_19_Infographic_1_.pdfGreat synopsis. |
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Post by ericn on Mar 20, 2020 13:09:12 GMT -6
Last night I was talking to a Hospital admin. I have known since childhood and I pointed something out that I feel is really getting lost in this whole thing: Dr’s nurses and allied health are not our fist line of defense in all this, it is cleaners, transport staff ect. The fact is we are both in health care and elsewhere leaning very heavily on the least compensated and thus those with the least ownership.
Even in my building the fairly we compensated office staff is working from home while 3 construction projects are going on. The building is really in the hands of the uninsured sub $15 an hour guard staff. How long before the stress of the jobs in general plus the fear causes carelessness or they simply walk? What do we do then?
In my wife’s own lab the pathologists ( MD’s) are doing everything but bench work from home, but the techs still need to be in a lab that shares a wall with the negative pressure isolation room. I did of course remind my wife who felt like a second class citizen that when the shit hits the fan and full emergency plan goes into effect the paths would be basically serving in a nursing role ( you want a doc who hasn’t intimated a patient in 20 years as your doc) but their MD meant they could legally do the work of RN’s.
Now where this becomes important and personal is that we almost died from MSRA because a cleaner didn’t use a fresh mop head in each room against protocol. Think of this in the case of the ones you love.
ERICN
Professional Patient
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Post by ragan on Mar 20, 2020 13:18:43 GMT -6
Good article from Peter Zeihan, a geopolitical analyst I rather like. //// Coronavirus manages to play into our weaknesses in a big way. Our brains are bad at comprehending risk, understanding probability, anticipating and accepting big changes, or dealing with uncertainty. So if this crisis has hit you like a ton of bricks, you’re not alone. And don’t worry, those spring breakers in Miami? They’ll have their own…moment. I’m sure you’ve guessed from our company name – Zeihan on Geopolitics – that we are not doctors. But making the world a bit more comprehensible is what we do, so we have turned our efforts to compiling the best information that we could find to help you understand the virus and protect yourself. I assure you this is purely selfish. If you all get sick, who will read our stuff? There are three reasons you should stay home and try your damndest not to get coronavirus. The first is that we do not know enough about the virus. Yes, it’s been around for 3+ months, but in part because of the Chinese attitude towards information control and in part because of the nature of viral medicine our understanding is limited. We don’t know if there are long-term consequences to infection for those that recover, but there are indications coronavirus can leave patients with permanent lung damage. There could be other permanent damage. We won’t know until we have people who have survived it get fully checked out months after their recovery. That will take, well, months. Second, you need to protect yourself and your family. Yes, about half of cases are so mild that they’re mistaken for a mild cold. But “mild” in the medical lexicon means something else: that you simply don’t need to go to the hospital. Another roughly 30% of the cases are that flavor of “mild”: people who experience the worst flu-like symptoms of their life. The next level up, “severe” affects an estimated 15% of cases. These people end up in the hospital because they require supportive oxygen treatment and are hardly able to use the bathroom on their own. Are most of these “severe” cases older and/or suffering from pre-existing conditions like asthma? Absolutely. Are they all? Absolutely not. Finally, about 5% of sufferers experience “critical” symptoms. They need a ventilator to breathe. That’s the fancy way of saying they need to be on life support. The largest study – one out of China – indicates half the people in this category didn’t make it (although keep in mind that it appears roughly half of all cases are so mild that they were never diagnosed with coronavirus in the first place, so it’s believed the true fatality rate is far closer to 1% of all cases than 2.5%... as long as hospitals are functioning). Which brings us to the final reason you should take this seriously. Regardless of the country you consider, no hospital has enough ventilators. America has more critical care beds than anyone else (almost more than everyone else) and we only have 100,000. Those who recover successfully from the “critical” category need a week or so of intensive care. That means if everyone lines up and gets sick in a very orderly process, and no one anywhere has a heart attack or stroke or gets in a car accident or gets stabbed or shot or otherwise needs critical care, it’ll take nearly three years to cycle through everyone who coronavirus puts into ICU. Even then, this pie-in-the-sky scenario only gives everyone precisely one week of treatment. For many that simply isn’t enough. But with hospitals overloaded, no one will be allowed to linger in those critical care beds. We have a word for what happens when you have to choose who gets help. Who to save. Triage. The Italians and Iranians have been mournfully struggling with that for days. They now have guidelines for who gets any time in critical care and who is left to die. In the worst-case scenario, four times as many Americans will die than during the whole of World War II, including the lives of doctors and nurses risking their lives for you and everyone you love. You can literally save lives by staying home and binging Netflix. So do it. Now. Link to full size pdf mcusercontent.com/de2bc41f8324e6955ef65e0c9/files/5860f4a6-8b00-40e6-90a6-3574a8af0a95/PZ_COVID_19_Infographic_1_.pdfCould you post a link to that Zeihan article? I want to share it and can’t seem to find it. |
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Post by matt@IAA on Mar 20, 2020 13:25:07 GMT -6
It was an email, I’ll forward.
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Post by Deleted on Mar 20, 2020 18:19:13 GMT -6
What I see from a european perspective, is, that people still have no intuitive understanding of exponential processes, which is understandable, most people have a problem with anything more but linear processes in terms of intuitive handling. What people understand is, that, if handling of Covid-19 is underestimated, especially if healthcare systems are not prepared with many intensive care beds, which most are not, you have really catastrophical situation soon. In Italy, the dead have been transported with military trucks now, two days ago, if I remember it right, in high counts. Hard cuts into the rights of incarcerated people lead to prison riots across the country. It is a kind of worst case management due to taking the required measurements too late.
The worse the healthcare system, the worse the countries management of quarantine and other measures, the more deadly cases and problems in society overall you will have. And this will not be over in a few weeks.
Covid-19 might be not as deadly as MERS or SARS1, but it is very contagious, probably we will have 60-80% of mankind beeing infected in the end. Probably this will take up to two years or even more, with several waves of infection before there is a high enough immunity in the human population, i.e. 50-75% immunity due to a healed infection or vaccination, which will be available next year earliest. This is the immunity percentage to be on a more safe side due to herd immunity (= end of crisis).
Germany is in the process to flatten the curve massively, with cuts into social life as much as is needed.
It stays uncertain, how this all will develop, what works and what doesn't.
Between paranoic and absolutely reasonable, there is only a small difference sometimes.
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Post by drbill on Mar 20, 2020 18:30:09 GMT -6
or vaccination, which will be available next year earliest. . I'm hearing there is much progress from a wide variety of sources in the vaccine and treatment fronts. (you can see my previous post). I'm cautiously optimistic in those regards, but taking absolute maximum lockdown precautions as much as possible. Not only for my family (of whom several are high-highest risk) as well as the rest of humanity. We've got the best and the brightest with a HUUUUUUUGE incentive of MEGA-$$$ for a company to come out with the "answer" / solution. They are most definitely "ON IT!" |
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Post by Deleted on Mar 20, 2020 18:36:38 GMT -6
An interesting thought experiment I came across was following:
Let's say, the infection kills one percent of the people of a country, due to population age structure etc.---
This would be like a box filled with 100 chocolate candies.
One of them is poisoned with a deadly venom.
Would you take one? Mmmmm?
Or would you pass it over to your mom after someone poisoned 10 of them?
It makes the problem of underestimating probablilities more vivid.
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Post by drbill on Mar 20, 2020 18:37:14 GMT -6
Ps - I was on the phone with a publisher that thinks all this precaution is obsurd. Very smart guy. And he's just not "getting" it. Plenty of folks all over going about daily duties as if things were normal. Not sure what to make of that other than they really don't understand the concept of "exponential". Bottom line, right or wrong, we'll all know the outcome in a few months.
if you are able to change things up into a new normal of lockdown / social distancing / etc., please do. <thumbsup>
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Post by saltyjames on Mar 20, 2020 18:40:53 GMT -6
One more time my dad is long time MD with many decades of experience.
The truth is:
Nothing special is happening the numbers speak truth it's a virus, and we have viruses every winter time.
The only difference is this time WHO and media make a big hype about it.
MDs are all the time around viruses and bacteria - do we have an MD mass extinction? No, we don't have this it's a normal viral infection thing going around, like with many other viruses too... BTW which no one is talking about anymore.
There is a big hype around this. And another thing is funny they are closing schools and big events. But you can't lock up a virus, that's a fact.
It's also a fact that we can find now in 40% of the population Covid19 antibodies.
There is no reason for hysteria. Like with any other flu season its wise to do the following things.
1. Wash your hands with hot water and soap.
2. Outside walks are good, have some fresh air get some sun if it's there.
3. Science has proven that high doses of vitamin D are eight hundred times stronger than the yearly flu shot.
4. Eat healthy food don't drink don't smoke.
All due respect, I will continue to listen to people whose careers and training revolve around the spread of infectious disease. They are at odds with what you say your dad believes. I realize you think differently and that your dad is an MD, you don’t need to keep repeating it. I’m not trying to convince you to change your mind on anything. Easy... MrHolmes is actually the only person making sense in all this. And he is 100% correct. The real problem is that even most medical personnel are clueless on the actual science of viruses. This is a complete media shit show. |
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Post by ragan on Mar 20, 2020 18:43:19 GMT -6
All due respect, I will continue to listen to people whose careers and training revolve around the spread of infectious disease. They are at odds with what you say your dad believes. I realize you think differently and that your dad is an MD, you don’t need to keep repeating it. I’m not trying to convince you to change your mind on anything. Easy... MrHolmes is actually the only person making sense in all this. And he is 100% correct. The real problem is that even most medical personnel are clueless on the actual science of viruses. This is a complete media shit show. Ok well I’ll be sure to make a mental note that some random dude on the internet has allowed himself to become convinced that medical professionals are clueless about medical science. |
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Post by Tbone81 on Mar 20, 2020 18:44:48 GMT -6
Good news here in the Oregon region...we're now greatly ramping up testing and turn around time is 24 hours, down from 3 days. We're going to see a huge up take in confirmed covid cases, and thats going to panic alot of people...BUT...thats excellent news, because it really just means that we're able to identify the people who have been infected this whole time. It's going to help our hospital immensely when it comes to saving resources. Right now we have 10 rule out patients for every confirmed cased. Thats 10x the resources being used than actually needed. So don't panic over the numbers, you have to wait it out to see what the numbers will really look like.
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Post by Deleted on Mar 20, 2020 18:46:34 GMT -6
Personally, I would be very conservative or cautious with estimation of research success for vaccination. It is not a matter of $$$ only. I guess it is not even know if and how the virus will mutate in future. Until now we know 2 mutations, if I am correctly informed. And there are more uncertainties. The german health department estimated early next year as a reasonable research and production period until a usable vaccination would be available. Still, this might be a major tool to minimize the time for proper immunisation.
We will see ...
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Post by Deleted on Mar 20, 2020 18:59:02 GMT -6
Ps - I was on the phone with a publisher that thinks all this precaution is obsurd. Very smart guy. And he's just not "getting" it. Plenty of folks all over going about daily duties as if things were normal. Not sure what to make of that other than they really don't understand the concept of "exponential". Bottom line, right or wrong, we'll all know the outcome in a few months. if you are able to change things up into a new normal of lockdown / social distancing / etc., please do. <thumbsup> Absolutely I think the understanding of "exponential" is crucial to get the seriousness of the situation and therefore the biggest problem. How few people have this understanding you can see, if you ask people how they think a climate change works, or even more practical, how interest accumulates on consumer credits. How banks and money works. Everyday concepts most people have no clue, how it actually works, due to lack of understanding of "exponential" . |
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Post by rowmat on Mar 20, 2020 19:12:46 GMT -6
The concept of Exponential Growth should be a mandatory subject taught at all schools and regularly revisited using real world examples to show how easily humans can be caught out. Citing this example below from Chris Martenson (Peak Prosperity) we are now at 12.45pm on the clock and most still cannot see the Tsunami that is about to hit. www.peakprosperity.com/video/crash-course-chapter-4-compounding-is-the-problem-2/Ps - I was on the phone with a publisher that thinks all this precaution is obsurd. Very smart guy. And he's just not "getting" it. Plenty of folks all over going about daily duties as if things were normal. Not sure what to make of that other than they really don't understand the concept of "exponential". Bottom line, right or wrong, we'll all know the outcome in a few months. if you are able to change things up into a new normal of lockdown / social distancing / etc., please do. <thumbsup> |
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Post by ragan on Mar 20, 2020 22:43:21 GMT -6
It's not just about a non-understanding of the math. There has been a heavily-curated ideology of anti-expertise being pushed for the last couple of decades. Amplified a lot more lately of course. It has (successfully) gotten its adherents to attach their identities to the belief that the people with the most training and experience in a given field are really just crooked ElitesTM and that the real knowledge can only be found on <insert mouthpiece du jour>.
It's impenetrable in most cases.
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