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Author Topic: COVID-19 | science, damage limitation, NO POLITICS  (Read 86369 times)

Robert Roaldi

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Re: COVID-19 | science, damage limitation, NO POLITICS
« Reply #180 on: March 28, 2020, 10:48:17 pm »

A friend sent this report about UV radiation use in decontamination, https://www.bbc.com/future/article/20200327-can-you-kill-coronavirus-with-uv-light.

UV radiation is used in commercial applications but requires specialized equipment and training. The takeaway is that there doesn't seem to be any obvious way to use it in a consumer setting. You can't disinfect all your groceries at the exit door by walking through a UV room, not safely. The info about UVC (as opposed to UVA and UVB) was new to me.
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Slobodan Blagojevic

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Re: COVID-19 | science, damage limitation, NO POLITICS
« Reply #181 on: March 29, 2020, 10:56:29 am »

(Cross-posting from another Corona thread)

Today's stats from Serbia, FWIW:

From top to bottom, left to right:

Total number, dead, recovered, active cases, tested. Serbia's population is about 7-8 million.

The second image is a makeshift hospital for milder cases in a fairground facility.

Chris Kern

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Re: COVID-19 | science, damage limitation, NO POLITICS
« Reply #182 on: March 29, 2020, 11:07:49 am »

UV radiation is used in commercial applications but requires specialized equipment and training. The takeaway is that there doesn't seem to be any obvious way to use it in a consumer setting.

The only practical consumer use for it that I've seen is in cellphone "sanitizers."  These might be useful for people who need to use their phones it settings where they are in contact with people who are shedding COVID-19 or other viruses―for example, doctors or other medical workers.

armand

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Re: COVID-19 | science, damage limitation, NO POLITICS
« Reply #183 on: March 29, 2020, 11:38:38 am »

The only practical consumer use for it that I've seen is in cellphone "sanitizers."  These might be useful for people who need to use their phones it settings where they are in contact with people who are shedding COVID-19 or other viruses―for example, doctors or other medical workers.

I got one because our phones are one the most contaminated objects to start with.



armand

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Re: COVID-19 | science, damage limitation, NO POLITICS
« Reply #184 on: March 29, 2020, 11:39:36 am »

(Cross-posting from another Corona thread)

Today's stats from Serbia, FWIW:

From top to bottom, left to right:

Total number, dead, recovered, active cases, tested. Serbia's population is about 7-8 million.

The second image is a makeshift hospital for milder cases in a fairground facility.

I heard the Detroit auto show was canceled and they will use the facility for something similar.

armand

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Re: COVID-19 | science, damage limitation, NO POLITICS
« Reply #185 on: March 29, 2020, 12:55:05 pm »

Slobodan Blagojevic

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Re: COVID-19 | science, damage limitation, NO POLITICS
« Reply #186 on: March 29, 2020, 01:04:00 pm »

Italian stats:

The data set is from 6,000 deaths. Anecdotally, overweight men are the majority of patients and the data confirm it.

Alan Goldhammer

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Re: COVID-19 | science, damage limitation, NO POLITICS
« Reply #187 on: March 29, 2020, 03:25:05 pm »

Italian stats:

The data set is from 6,000 deaths. Anecdotally, overweight men are the majority of patients and the data confirm it.
There is a lot of interesting epidemiology data coming out and I'm sure we will continue to see interesting things.  I want to see if there is a positive correlation between blood type and infectivity.  Early information shows those with Type A are more prone to infection.  Also people on certain blood pressure meds may have resistance based on some AI analyses of possible drugs that interfere with viral binding.
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Paulo Bizarro

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Re: COVID-19 | science, damage limitation, NO POLITICS
« Reply #188 on: March 30, 2020, 04:51:51 am »

Even though in some countries - like mine, Portugal - the recommendation from WHO - test, test, test - is not possibel (lack of supplies due to non-preparedness), the amount of data worldwide is enormous. Only in Portugal, in March, 40,000 tests were done.

The amount of data at the end of this crisis will no doubt be analysed by AI and Big Data algorithms, and hopefully lessons will be learned for the future. Recently researchers from Imperial College have made some analysis for 202 countries. For Portugal, without efficient quarantine methods, they estimate 70,000 infected and nearly 4,000 dead.

Bart_van_der_Wolf

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Re: COVID-19 | science, damage limitation, NO POLITICS
« Reply #189 on: March 30, 2020, 06:10:22 am »

Interesting, although alarming, new insights are emerging.

In the current ICU capacity planning in my country, an average period of 10 days in ICU per patient was used for some capacity planning models. However, the actual minimum period that people with Covid-19 have to remain in ICU's turns out to be more like 21 days, effectively halving the available capacity.

Do note that the absolute number of ICU days per patient will differ by country, also because of differences in treatment leading up to ICU admission. Traditionally, the ICU period is relatively short in the Netherlands. Currently cohort departments are being opened where patients can receive treatment for lighter respiratory relief, to reduce the load on ICU's.
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Alan Goldhammer

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Re: COVID-19 | science, damage limitation, NO POLITICS
« Reply #190 on: March 30, 2020, 07:44:06 am »

The amount of data at the end of this crisis will no doubt be analysed by AI and Big Data algorithms, and hopefully lessons will be learned for the future.
this has already started.  In 2005, my colleagues and I developed a business plan to establish an organization that would improve the way observational medical information could be used to examine pharmaceutical safety and efficacy.  I made a presentation of industry CEOs in 2008, requesting an initial $20 million to get the project up and running.  A lot of new methods were developed and the group turned into a world wide group of industry, government and academic researchers.  Their international meeting that was to have taken place last week was cancelled and they used the time to create a giant COVID-19 study-a-thon with virtual meetings of work groups taking place over a five day period.  More than 340 collaborators took part, 180 hours, 30 nations over six continents, in 17 different teams.
They wrapped up things last night and have a number of very good ideas that can be implemented moving forward.  If you have a technical interest, here are the links:  https://www.ohdsi.org/covid-19-updates/

Though I retired in 2010, this is my most important work accomplishment.
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armand

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Re: COVID-19 | science, damage limitation, NO POLITICS
« Reply #191 on: March 30, 2020, 08:24:13 am »

Interesting, although alarming, new insights are emerging.

In the current ICU capacity planning in my country, an average period of 10 days in ICU per patient was used for some capacity planning models. However, the actual minimum period that people with Covid-19 have to remain in ICU's turns out to be more like 21 days, effectively halving the available capacity.

Do note that the absolute number of ICU days per patient will differ by country, also because of differences in treatment leading up to ICU admission. Traditionally, the ICU period is relatively short in the Netherlands. Currently cohort departments are being opened where patients can receive treatment for lighter respiratory relief, to reduce the load on ICU's.

Statistics are good if you have the right numbers and the right intentions/algorithms. Some people will spin any data towards what they want to prove.

In regards to the length of stay in the ICU, it depends. The very sick patients will require a significant amount of time in the ICU although some initial anecdotal data that I've seen suggests the inflammation/infection per se doesn't last that long. You deal after with your comorbidities and if you are unlucky with the exaggerated response from your immune system. So overall the length of stay will depend on your patient population in the area, both comorbidities and life choices. Cultural differences play a role on how much they want to be on a ventilator, should they have the option.

Balancing this however is the clear trend to intubate early. This is usually 2 fold: many of those who require a lot of noninvasive support will decompensate anyway, and those noninvasive methods (high flow oxygen, CPAP/BiPAP) lead to significant aerosolizaton which turned out to be a big problem with Covid.

Paulo Bizarro

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Re: COVID-19 | science, damage limitation, NO POLITICS
« Reply #192 on: March 30, 2020, 09:59:32 am »

Interesting, although alarming, new insights are emerging.

In the current ICU capacity planning in my country, an average period of 10 days in ICU per patient was used for some capacity planning models. However, the actual minimum period that people with Covid-19 have to remain in ICU's turns out to be more like 21 days, effectively halving the available capacity.

Do note that the absolute number of ICU days per patient will differ by country, also because of differences in treatment leading up to ICU admission. Traditionally, the ICU period is relatively short in the Netherlands. Currently cohort departments are being opened where patients can receive treatment for lighter respiratory relief, to reduce the load on ICU's.

Unfortumately, no country is prepared for this... in Portugal, we try to follow the rule of 80-15-5, that is, 80% patients are treated at home (mild cases), 15% in hospitals, and 5% in ICUs. Thus far, today we have 127 deaths, mostly above 70 years old. Bad news: 50% of people that go into ICU die. Germany seems to be a good case of having enough hospital and ICU resources.

In Portugal, also people who have recovered (43 so far) on average spend 3 weeks in recovery. So yes, 10 days seems awfully optimistic.

Paulo Bizarro

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Re: COVID-19 | science, damage limitation, NO POLITICS
« Reply #193 on: March 30, 2020, 10:03:40 am »

this has already started.  In 2005, my colleagues and I developed a business plan to establish an organization that would improve the way observational medical information could be used to examine pharmaceutical safety and efficacy.  I made a presentation of industry CEOs in 2008, requesting an initial $20 million to get the project up and running.  A lot of new methods were developed and the group turned into a world wide group of industry, government and academic researchers.  Their international meeting that was to have taken place last week was cancelled and they used the time to create a giant COVID-19 study-a-thon with virtual meetings of work groups taking place over a five day period.  More than 340 collaborators took part, 180 hours, 30 nations over six continents, in 17 different teams.
They wrapped up things last night and have a number of very good ideas that can be implemented moving forward.  If you have a technical interest, here are the links:  https://www.ohdsi.org/covid-19-updates/

Though I retired in 2010, this is my most important work accomplishment.

Alan, this is much appreciated. I will certainly spend some time going through it, even though I am a geologist:)

And congratulations for participating in such initiatives.

Bart_van_der_Wolf

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Re: COVID-19 | science, damage limitation, NO POLITICS
« Reply #194 on: March 30, 2020, 10:44:15 am »

A good Q&A with Dr. Fauci:

Dr. Fauci Answers Trevor’s Questions About Coronavirus
https://www.youtube.com/watch?v=8A3jiM2FNR8

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Manoli

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Re: COVID-19 | science, damage limitation, NO POLITICS
« Reply #195 on: March 30, 2020, 10:45:40 am »

Race to find COVID-19 treatments accelerates
Full article: https://science.sciencemag.org/content/367/6485/1412.full

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Alan Klein

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Re: COVID-19 | science, damage limitation, NO POLITICS
« Reply #196 on: March 30, 2020, 11:10:18 am »

Interesting, although alarming, new insights are emerging.

In the current ICU capacity planning in my country, an average period of 10 days in ICU per patient was used for some capacity planning models. However, the actual minimum period that people with Covid-19 have to remain in ICU's turns out to be more like 21 days, effectively halving the available capacity.

Do note that the absolute number of ICU days per patient will differ by country, also because of differences in treatment leading up to ICU admission. Traditionally, the ICU period is relatively short in the Netherlands. Currently cohort departments are being opened where patients can receive treatment for lighter respiratory relief, to reduce the load on ICU's.
In New York Columbia Presbyterian Hosp where I had my heart surgery last year, they have converted two floors used for heart surgery to ICU's for the virus.  I wonder how many heart and other surgeries are being put off because of Covid-19?  How do you count heart disease and other non-virus deaths that might be occurring that would not have  if the surgeries and other medical procedures were done on a timely basis? 

I understand this disease has priority so please don't attack me.  I'm just trying to make a point that there are other medical problems and deaths that aren't being addressed because of the pandemic.  Those figures will have to be included in the count when this whole thing is over. 

Alan Klein

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Re: COVID-19 | science, damage limitation, NO POLITICS
« Reply #197 on: March 30, 2020, 11:16:15 am »

Make more PPE, everyone needs the stuff.  Also remember if someone who is positive comes to an MD or urgent care office and sneezes or coughs you need to the have the tools to decontaminate things.  Maybe they will dedicate a special room for taking the swab samples.  this is not as easy a problem to solve.
I spoke to a friend who's in Florida for vacation and had to go to the doctor there. He waited outside in his car until the last patient left. Then went in. The receptionist was behind a glass barrier and a nurse was wearing a mask. The doctor barely touched him and wasn't wearing a mask.    The doctor was a urologist.  So I asked my friend if the doctor asked him to test himself?  My friend said that no the doctor was prepared. Apparently the procedure calls for the doctor to wear a glove in any case.  :)

Bart_van_der_Wolf

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Re: COVID-19 | science, damage limitation, NO POLITICS
« Reply #198 on: March 30, 2020, 11:27:16 am »

I understand this disease has priority so please don't attack me.  I'm just trying to make a point that there are other medical problems and deaths that aren't being addressed because of the pandemic.  Those figures will have to be included in the count when this whole thing is over.

Alan, I can only speak for what I'm told in the Dutch context. Urgent care is being given to other patients. Yesterday e.g. a heart transplant was performed in a Dutch Hospital, and other ICU care was administered to those who need it.

Planned operations may be postponed for a week or so until it becomes clearer that the ICU capacity will be available (the Covid-19 reproduction rate in the Netherlands seems to have dropped to 1.0 or less), but the Covid-19 patients take up beds that would otherwise have been empty, or they take up the additional beds that were, and still are being created specifically for them (we expect another peak in 1 week time). We also move patients around in the country to make space for the locally anticipated needs, and we even exchange space with our neighboring countries (especially Germany has a large spare ICU capacity).
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Paulo Bizarro

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Re: COVID-19 | science, damage limitation, NO POLITICS
« Reply #199 on: March 30, 2020, 11:46:00 am »

In New York Columbia Presbyterian Hosp where I had my heart surgery last year, they have converted two floors used for heart surgery to ICU's for the virus.  I wonder how many heart and other surgeries are being put off because of Covid-19?  How do you count heart disease and other non-virus deaths that might be occurring that would not have  if the surgeries and other medical procedures were done on a timely basis? 

I understand this disease has priority so please don't attack me.  I'm just trying to make a point that there are other medical problems and deaths that aren't being addressed because of the pandemic.  Those figures will have to be included in the count when this whole thing is over.

In Portugal, hospitals are set up with covid and nocovid areas. All non-urgent medical treatments are post-poned. In the last few days two trends have emerged:

- infections in home care houses for older people, many private, and that have done very little to be prepared... ending up with both staff and residents infected.

- 800+ medical staff infected.

Next up are prisons.

All of the above could have been prevented with proper and timely planning and preparation. It ispathetic to see the minister of Health saying that the numbers of how many residents exist in caring homes is "not clear".
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