COVID-19 | science, damage limitation, NO POLITICS

[armand]

Thank you!
It's interesting that their conclusion is contradictory with that first report.

First reports were using either incomplete theory, or more often they saw an association but failed to account for confounders. Such as more people with HTN die, people who have HTN are more often on ACEI, therefore ACEI are bad. Maybe more people with HTN die because they are older or have other comorbidies or other unaccounted factors.

That being said, this study is better quality but remains a retrospective study. The gold standard is well designed double-blind, randomized prospective.

[John Camp]

One aspect of what you might call "fractured" openings like the one in Georgia, where a lot of people disagree on exactly what should be done or how the reopening should be handled: If a hairdresser opens in a town, and others don't, the ones that don't will be at a serious disadvantage competitively downstream, as former clients go to the open hairdresser. So there will be pressure for everyone to open, even those who fear infection and would rather not open. Same with those other businesses that the Georgia governor allowed to open -- gyms, barbershops, etc. I think it would be more equitable if a widely agreed-upon date were chosen, and then everybody opened.

A second thought: if a hairdresser opened, got infected, and passed it on to a few dozen clients, then maybe that wouldn't turn out to be a competitive advantage.

[armand]

New York antibody study estimates 13.9% of residents have had the coronavirus, Gov. Cuomo says.  That's 2.7 million people out of 19.4 residents.
https://www.cnbc.com/2020/04/23/new-york-antibody-study-estimates-13point9percent-of-residents-have-had-the-coronavirus-cuomo-says.html

Note that NYC had the highest rates with upstate the lowest.

The more were already infected the better but on the short term this doesn't change that much the sheer number of people getting sick from this in a very short amount of time, that you have to deal with. On the long term there is hope the total numbers are not going to go that high even with reopening, however we need more thorough testing to confirm this.

[LesPalenik]

Yawn. Wake me up when it passes the usual 50-60K deaths from regular flu every year (in the States).

Pleased to oblige. At what time do you want the wake up call, Sir?
50K tomorrow morning, 60K next week, 100K next month.

[John Camp]

Pleased to oblige. At what time do you want the wake up call, Sir?
50K tomorrow morning, 60K next week, 100K next month.

Should hit 50k this evening. According to the Worldometer count, we were at 49651 at mid-afternoon.

[armand]

Pleased to oblige. At what time do you want the wake up call, Sir?
50K tomorrow morning, 60K next week, 100K next month.

I would also add that the usual for flu is ~ 40k/year. The 60K was the highest in the last at least 10 years. There was another one at 50K and all others were around 40K or less: https://www.cdc.gov/flu/about/burden/index.html

[Alan Klein]

A researcher working for the Federal government whpo heads infectious disease group as part of the Homeland Defense has a study they did on the half life of Covid 19.  Apparently, the higher the temperature and humitdit, the less they last.  So summertime weather should reduce spreading somewhat although he said that their research should not affect the CDC guidelines yet.  It's really significant the difference.  Also, sunlight and UV really kills them as does Isopropyl alcohol and some other common antisdeptic house cleaners.  They were suppose to update which ones are best but I don't know when and where they're doing that. 

[Alan Klein]

The more were already infected the better but on the short term this doesn't change that much the sheer number of people getting sick from this in a very short amount of time, that you have to deal with. On the long term there is hope the total numbers are not going to go that high even with reopening, however we need more thorough testing to confirm this.

We're already past the point where hospitals are now able to handle the case load, the main argument for flattening the curve.  I think a study in Los Angeles shows high rates of infection there as well.  I think the point is that once you realize there's an outbreak, it's already spread through the community.  So isolation at that point is somewhat late.  The other point is that the community is gaining natural immunity for future outbreaks.  Wouldn't it be interesting if we find that next year, NYC and NJ are two areas that won't suffer as much with higher infection rates as other areas in the country that were hardly affected this year? 

[LesPalenik]

A researcher working for the Federal government whpo heads infectious disease group as part of the Homeland Defense has a study they did on the half life of Covid 19.  Apparently, the higher the temperature and humitdit, the less they last.  So summertime weather should reduce spreading somewhat although he said that their research should not affect the CDC guidelines yet.  It's really significant the difference.  Also, sunlight and UV really kills them as does Isopropyl alcohol and some other common antisdeptic house cleaners.  They were suppose to update which ones are best but I don't know when and where they're doing that.

Hot weather might help somewhat, but Florida was hit quite hard. Actually, the southern Florida with temperatures in 80's has been hit harder than the northern Florida. Also other warm countries like Spain, Italy and France although now flattening, are still showing significant number of new cases and deaths. And most infections are and will continue to be spread out indoors.

[Alan Klein]

Hot weather might help somewhat, but Florida was hit quite hard. Actually, the southern Florida with temperatures in 80's has been hit harder than the northern Florida. Also other warm countries like Spain, Italy and France although now flattening, are still showing significant number of new cases and deaths. And most infections are and will continue to be spread out indoors.

If someone coughs on you who is infected, it won't matter the temperature. You'll breathe it right in.  The temperature and humidity have to do with the half life of how long the virus stays communicable on different surfaces.  So if there was let's say some spit with virus on a door knob in the sun, it might last 5 minutes as opposed to 1 1/2 hours in the shade.  Similar variables occur with tempos and humidity: the higher they are, the less time the virus can last on the surface.  Something interesting i just thought of.  Apparently higher temps and humidity help the virus once inside the body since our temps are 96 F degrees and near saturation in the mucus membranes of our body.  But by then, the body cells may actually be "feeding" the virus so a different scenario is taking place from when they're "stuck" on an external surface.

[faberryman]

If someone coughs on you who is infected, it won't matter the temperature. You'll breathe it right in.  The temperature and humidity have to do with the half life of how long the virus stays communicable on different surfaces.  So if there was let's say some spit with virus on a door knob in the sun, it might last 5 minutes as opposed to 1 1/2 hours in the shade.  Similar variables occur with tempos and humidity: the higher they are, the less time the virus can last on the surface.  Something interesting i just thought of.  Apparently higher temps and humidity help the virus once inside the body since our temps are 96 F degrees and near saturation in the mucus membranes of our body.  But by then, the body cells may actually be "feeding" the virus so a different scenario is taking place from when they're "stuck" on an external surface.

Dr. Klein, have you checked this out with Dr. Trump. I understand he is now suggesting injections of disinfectant. Perhaps you two could work this out together. Maybe win that Nobel Prize he has been hankering for.

[John Camp]

As I noted earlier, we'll go past 50,000 deaths tonight. One month ago, on March 23rd, we had 550 deaths, so we've had better than 49,000 in a month. This according to Johns Hopkins and also the statistical site at Worldometer. If I wasn't such a cheerful guy, I'd be seriously bummed. When it was just modeling, it seemed kind of theoretical; but now the mound of bodies is building into a mountain. We'll be at 60,000 by Tuesday or Wednesday.

Edit: I forgot to put in the number from the JH and Worldometer sites: 49, 861 dead in the US as of the evening of April 23.

[Alan Klein]

Dr. Klein, have you checked this out with Dr. Trump. I understand he is now suggesting injections of disinfectant. Perhaps you two could work this out together. Maybe win that Nobel Prize he has been hankering for.

Frank I think you're being political.  You know that's a no-no.  On the other hand, I think alcohol as a disinfectant has wonderful possibilities to clear the virus out of your throat membranes.  I wonder how effective a rum and Coke might be?

[Alan Klein]

Interesting graphic video of how pandemics spread based on different parameters.  It runs about 20 minutes to cover all of them and is very interesting.  I found it well worthwhile.
https://www.youtube.com/watch?v=gxAaO2rsdIs

[Jonathan Cross]

The situation in the UK is staring to change.  B&Q, a large DIY chain, has reopened stores.  There will be transparent screens in front of till staff, strict social distancing, and control of the number of customers in a store at any one time.  It will be interesting to see how this goes as many of the stores have a garden department and sell plants, yet garden  centres had to close and still are, meaning the binning of millions of plants.

Jaguar Landrover is also going to start production again, and Taylor Woodrow, a large construction company, is starting up again.

There seems to be a feeling though that social distancing will be here for quite some time.  For the 5th week, right across the country at 8pm last evening millions of people came out, kept apart and clapped, cheered and banged saucepans for all those working in the National Heath Service who have had to change so fast and care for so many, yet keep their emotions under control and keep safe themselves.  As one nurse said each one who dies from the virus has a name, is a real person, has friends and relations, and it is so sad to lose them. 

The community help has been amazing, with so many going out of their way to help those who are self-isolating for whatever reason, by doing shopping, ringing up for a chat to keep in touch and so much more.  We have people making scrubs (uniforms) for health staff, with Lions and Rotary providing money for the material and patterns, and so much else happening.

Best wishes,

Jonathan

[faberryman]

Frank I think you're being political.  You know that's a no-no.

No, I was only interested in your scientific analysis of injecting disinfectants into the bodies of COVID-19 patients.

Another thing Dr. Trump suggested yesterday was using bright light inside the body, which got me thinking about my last colonoscopy. The doctor used a probe with a little light bulb at the end to illuminate the colon so he could look for anomalies with his camera. So I thought maybe we could replace the little light bulb with a very powerful light bulb, and then shove the probe really far up there until it reached the lungs and then shine a tremendous amount of light on the coronoviruus to kill them. What do you think?

Speaking of bright lights, I remember something Dr. Trump said during the 2016 debates. Do you remember when he was talking about the nuclear triad, he asked why we have nuclear weapons but never use them? Then I remembered the news reels from the 1940s when they were testing nuclear bombs. All the army guys wore really powerful sunglasses because of the tremendous pulse of light that is released when a nuclear weapon goes off. Voila! Why don't we detonate nuclear bombs in ICUs? I think that bright pulse of light might kill the virus, and it would be non-invasive. As an added bonus, we could treat more than one patient at a time. I know what you are going to say: what about the radioactivity? That's where the radiologists get involved. Since radiologists know a lot about radioactivity, I am sure they could come up with a way to mitigate it. It would be a multi-disciplinary approach using radiologists and pulmonologists.

I don't want your political analysis, I want your scientific analysis. You are an expert, having watched YouTube a lot, and are poised to give some insightful analysis to these medical recommendations.

[elliot_n]

Coronavirus has been detected on particles of air pollution by scientists investigating whether this could enable it to be carried over longer distances and increase the number of people infected:

https://www.theguardian.com/environment/2020/apr/24/coronavirus-detected-particles-air-pollution

[Alan Klein]

No, I was only interested in your scientific analysis of injecting disinfectants into the bodies of COVID-19 patients.

Another thing Dr. Trump suggested yesterday was using bright light inside the body, which got me thinking about my last colonoscopy. The doctor used a probe with a little light bulb at the end to illuminate the colon so he could look for anomalies with his camera. So I thought maybe we could replace the little light bulb with a very powerful light bulb, and then shove the probe really far up there until it reached the lungs and then shine a tremendous amount of light on the coronoviruus to kill them. What do you think?

Speaking of bright lights, I remember something Dr. Trump said during the 2016 debates. Do you remember when he was talking about the nuclear triad, he asked why we have nuclear weapons but never use them? Then I remembered the news reels from the 1940s when they were testing nuclear bombs. All the army guys wore really powerful sunglasses because of the tremendous pulse of light that is released when a nuclear weapon goes off. Voila! Why don't we detonate nuclear bombs in ICUs? I think that bright pulse of light might kill the virus, and it would be non-invasive. As an added bonus, we could treat more than one patient at a time. I know what you are going to say: what about the radioactivity? That's where the radiologists get involved. Since radiologists know a lot about radioactivity, I am sure they could come up with a way to mitigate it. It would be a multi-disciplinary approach using radiologists and pulmonologists.

I don't want your political analysis, I want your scientific analysis. You are an expert, having watched YouTube a lot, and are poised to give some insightful analysis to these medical recommendations.

Your post is political.  I wonder if the OP will object to a political post or will he ignore it because he agrees with you?  We'll see how honest he is.  In the meanwhile I'll answer your post in the other thread.

[chez]

Frank I think you're being political.  You know that's a no-no.  On the other hand, I think alcohol as a disinfectant has wonderful possibilities to clear the virus out of your throat membranes.  I wonder how effective a rum and Coke might be?

I think if you add a jigger of Lysol to that drink...you might have something there.

[Chris Kern]

An interesting new study, published yesterday by researchers at Imperial College (London), models the efficacy of various testing strategies for controlling COVID-19 infections.  Bottom line: testing healthcare workers is a high priority for this high-risk group while testing of the general population probably does not confer a significant incremental benefit in preventing the spread of the SARS-CoV-2 virus over self-isolation of symptomatic individuals and contact-tracing.

The World Health Organization has called for increased molecular testing in response to the COVID-19  pandemic,  but different countries have taken very different approaches.  We used a simple mathematical model to investigate the potential effectiveness of alternative testing strategies for COVID-19 control.  Weekly screening of healthcare workers (HCWs) and other at-risk groups using PCR or point-of-care tests for infection irrespective of symptoms is estimated to reduce their contribution to  transmission by 25-33%, on top of reductions achieved by self-isolation following symptoms.  Widespread PCR testing in the general population is unlikely to limit transmission more than contact-tracing and quarantine based on symptoms alone, but could allow earlier release of contacts from quarantine.  Immunity passports based on tests for antibody or infection could support return to work but face significant technical, legal and ethical challenges.   Testing is essential for pandemic surveillance but its direct contribution to the prevention of transmission is likely to be limited to patients, HCWs and other high-risk groups.

It appears this type of model could help those designing testing regimes to determine how best to efficiently deploy constrained resources, but presumably widespread testing of the general population is still necessary to make informed decisions about when and where it is safe to ease current governmental restrictions.