COVID-19 Health and Preparedness - Strictly Moderated

[braumeister]

Excellent information. I hadn't thought about the oxygen saturation, which is easy to check with a fingertip pulse oximeter. I normally only bring mine when I'm in the mountains, but it could prove useful here. They're not that expensive, and might be a good thing to order if you don't have one.

https://www.amazon.com/s?k=pulse+oximeter&crid=387AM0BR7DPZ9&sprefix=pulse+oxi%2Caps%2C177&ref=nb_sb_ss_i_1_9

 

[ERD50]

...

According to the WHO report on China, the largest source of infection was familial. Someone in the household gets infected, brings it home, and everyone else gets infected. Keeping kids home from school for 3-4 weeks is therefore a good option to slow the spread.

Maybe not when the consequences are considered? I mentioned elsewhere, when the news reported the school closings in Chicago, they followed up with a report that there will be more Park District programs available for these kids. And what are working parents going to do?

They said to reconsider having the Grandparents watch the kids, as they (the Grandparents) would likely be in the danger zone age-wise.

So instead of these kids coming into contact with a few adults (bus driver, teacher), they'll likely get shuttled all over, and handed off from one to another over the course of the week. I'm not so certain this is a good thing at all.

-ERD50

 

[GenXguy]

I mentioned elsewhere, when the news reported the school closings in Chicago, they followed up with a report that there will be more Park District programs available for these kids. And what are working parents going to do?
-ERD50

I saw someone ask one of the healthcare authorities whether it's ok to go to the park. They responded that kids shouldn't be close together. So, they need to be keeping their distance. Also, keep people away from the older people. That's why nursing homes are disallowing visitors.

 

[MichaelB]

Maybe not when the consequences are considered? I mentioned elsewhere, when the news reported the school closings in Chicago, they followed up with a report that there will be more Park District programs available for these kids. And what are working parents going to do?

They said to reconsider having the Grandparents watch the kids, as they (the Grandparents) would likely be in the danger zone age-wise.

So instead of these kids coming into contact with a few adults (bus driver, teacher), they'll likely get shuttled all over, and handed off from one to another over the course of the week. I'm not so certain this is a good thing at all.

-ERD50

At a school the children spend the entire day together in close contact. It is not possible to prevent them from touching each other. If children can be infected, which they clearly can, a school will become a major contributor to the spread of infection.

What to do with the children at home is a problem, and there is no easy solution. If the primary objective is to slow the spread of disease, this measure makes sense. The cost is high.

My DD’s employer already announced that while schools are closed they will pay an additional $100 per day for childcare, and give some PTO days.

 

[The Cosmic Avenger]

As Old Microbiologist pointed out, there are 5 strains of this virus, all circulating in the US. Presumably the strains, which result from mutations, are different in how much damage they do. Have there been any correlations drawn between the 5 strains and how sick people become yet? For example, are the strains in Italy more devastating than the ones found elsewhere? Are some strains less destructive if treated with the drugs with some efficacy that exist now, and do some strains not respond? Do we have geographical hot spots in the US for the more destructive strains? It seems like this information might be useful in deciding where to shut everything down completely and where to focus some types of treatment.

There's a good genomic analysis of the spread of COVID-19 at https://nextstrain.org/narratives/ncov/sit-rep/2020-03-13. (But I'm biased, the author is a cousin of ours, and a truly brilliant guy.)

 

[harllee]

MichaelB, thanks for the symptom list. Interesting it shows runny nose and sneezing--I had read usually no runny nose and sneezing with this virus but what I read must be wrong. This time of year I have allergies with runny nose and sneezing all the time. Also your list shows diarrhea--so that must be way everyone is buying toilet paper!

 

[JoeWras]

If the primary objective is to slow the spread of disease, this measure makes sense. The cost is high.

We're all going to, or are already, paying for this. It is going to hurt. Most of us are going to lose money one way or another. A few will profit off of this, but the vast majority will lose wages, shutter business, pay more for services they previously didn't require, lose investment income, bury relatives. Etc.

I'm just hoping we keep a spirit of cooperation and then we can hopefully share the pain and help each other out.

 

[michelek]

dw and i are in atlanta for about another month (dw had surgery here 2 weeks ago) and are starting to get concerned about getting back home (about 800 miles from here) when time comes. I don't anticipate any gas shortages, but if there are travel restrictions (by car) i fear we could be stuck. We have a decent amount of provisions here in atl, but i sure would much happier to be at home!

 

[Katsmeow]

I did an instacart order on Saturday . It was delivered today at 6 pm . My text was beeping constantly with substitutions but we got most of the stuff . I was just glad to get milk,eggs and bread .

Tried to place a Walmart delivery order and could not as there were no spots available today or tomorrow. So I thought I would try pickup. Same thing. No slots either day.

It isn't that big a deal as it isn't urgent right now. That is, we have other food we can eat but there are some things we are out of that we wanted to get. Literally as I was putting together the order, something would be in stock and 5 minutes later would be out of stock.

Oh -- most food items were limited to 2 of the specific item.

Will try again tomorrow.

 

[Ready]

The earliest delivery I can get from Amazon is now Saturday, and that is for items which are not even in demand. No signs of any paper towels, hand sanitizer or toilet paper anywhere to be found there either.

 

[ERD50]

At a school the children spend the entire day together in close contact. It is not possible to prevent them from touching each other. If children can be infected, which they clearly can, a school will become a major contributor to the spread of infection.

What to do with the children at home is a problem, and there is no easy solution. If the primary objective is to slow the spread of disease, this measure makes sense. The cost is high.

My DD’s employer already announced that while schools are closed they will pay an additional $100 per day for childcare, and give some PTO days.

Yes, but if they are taking part in a bunch of various activities instead (and being kids, they'll end up in close contact), and coming into contact a larger group of adults than they normally would, it might (or might not) be worse.

So your last example - now those kids are coming into contact with a different group of kids. I dunno, but I think this runs a very real risk of making things worse for the spreading the virus, while also making it hard on parents, school employees, etc.

-ERD50

 

[Clone]

Did anyone else catch the description of the testing procedure on the news conference? They push a swab up your nose until it reaches that back of your throat? A very unpleasant experience. I suspect that a number of folks who have been clamouring for testing may reconsider. I suspect most folks were thinking spit in the tube or swab the cheek, or worst case a blood draw.

 

[Aerides]

Did anyone else catch the description of the testing procedure on the news conference? They push a swab up your nose until it reaches that back of your throat? A very unpleasant experience. I suspect that a number of folks who have been clamouring for testing may reconsider. I suspect most folks were thinking spit in the tube or swab the cheek, or worst case a blood draw.

I decided to add a little more to your post for those seeking clarity:

First, here are the full remarks from yesterday's briefing referencing the test procedure:
https://www.whitehouse.gov/briefing...bers-coronavirus-task-force-press-briefing-3/
Yes, it describes "And there’s a swab that’s put in the back of the nose, all the way to the back of the throat — it’s called a nasal pharyngeal swab — which is then put in media."

USA Today describes the procedure as: "If the patient is calm, the swabbing takes a mere 10 seconds or so and is not painful. A jittery patient can make things more difficult."

(I'd rather hold still for 10 seconds than get squeamish about a test. )

 

[MichaelB]

Yes, but if they are taking part in a bunch of various activities instead (and being kids, they'll end up in close contact), and coming into contact a larger group of adults than they normally would, it might (or might not) be worse.

So your last example - now those kids are coming into contact with a different group of kids. I dunno, but I think this runs a very real risk of making things worse for the spreading the virus, while also making it hard on parents, school employees, etc.

-ERD50

You seem to be saying that closing school and keeping kids home makes them more exposed to infection, leading to more overall infections. Is this your point? If so, we disagree, as it goes against all the reasoning behind avoiding crowds, close contact, etc.

 

[ImThinkin2019]

There's a good genomic analysis of the spread of COVID-19 at https://nextstrain.org/narratives/ncov/sit-rep/2020-03-13. (But I'm biased, the author is a cousin of ours, and a truly brilliant guy.)

Thank you for linking to this paper. It was an excellent data-based summary and guide to good information. The writing was very precise and clear.

The presentation style was also unique. Liked it very much. Would love to know the author personally. Obviously smart.

 

[harllee]

Did anyone else catch the description of the testing procedure on the news conference? They push a swab up your nose until it reaches that back of your throat? A very unpleasant experience. I suspect that a number of folks who have been clamouring for testing may reconsider. I suspect most folks were thinking spit in the tube or swab the cheek, or worst case a blood draw.

This is the same test as for the regular flu-I had the flu test last year. No big deal --not painful and only took a few seconds. To me not nearly as bad as blood draw.

 

[audreyh1]

This is the same test as for the regular flu-I had the flu test last year. No big deal --not painful and only took a few seconds. To me not nearly as bad as blood draw.

I got a test for flu last year - wasn’t that bad.

 

[Nemo2]

https://www.news.com.au/lifestyle/h...l/news-story/93e7656da0cff4fc4d2c5e51706accb5

A team of Australian researchers say they’ve found a cure for the novel coronavirus and hope to have patients enrolled in a nationwide trial by the end of the month.

University of Queensland Centre for Clinical Research director Professor David Paterson told news.com.au today they have seen two drugs used to treat other conditions wipe out the virus in test tubes.

He said one of the medications, given to some of the first people to test positive for COVID-19 in Australia, had already resulted in “disappearance of the virus” and complete recovery from the infection.

Prof Paterson, who is also an infectious disease physician at the Royal Brisbane and Women’s Hospital, said it wasn’t a stretch to label the drugs “a treatment or a cure”.

“It’s a potentially effective treatment,” he said.

“Patients would end up with no viable coronavirus in their system at all after the end of therapy.”

The drugs are both already registered and available in Australia.

 

[JoeWras]

Yes, it describes "And there’s a swab that’s put in the back of the nose, all the way to the back of the throat — it’s called a nasal pharyngeal swab — which is then put in media."

USA Today describes the procedure as: "If the patient is calm, the swabbing takes a mere 10 seconds or so and is not painful. A jittery patient can make things more difficult."

(I'd rather hold still for 10 seconds than get squeamish about a test. )

This is the same test as for the regular flu-I had the flu test last year. No big deal --not painful and only took a few seconds. To me not nearly as bad as blood draw.

Correct. The professionals know how to do this efficiently.

I woke up overnight and CBS had some interesting segments. One was on the drive through testing. They showed the procedure a few times. People sat right in their cars. Nobody even flinched even as you saw the stick go back up there.

The other segment was an interview with one of their employees in Rome who is positive. They showed the Italians giving the test: same procedure. Then he discussed his illness. Extremely mild. Slight short fever, mild body ache and a "different" kind of cough, one that had an element of chest pain. He said it felt like he had just done a workout.

He's doing well and didn't cough the entire 8 minutes or so. They health authorities call him 3x per day and he gives his temperature reading. He is absolutely isolated in his apartment. He'll get more tests after he goes through the isolation period. For now, they are monitoring him to make sure he doesn't crash.

From his description it is very, very clear how this can spread so easily. There are plenty of people out there who think they have spring pollen fevers, or really just don't think about a few coughs. But they can spread it.

 

[REWahoo]

https://www.news.com.au/lifestyle/h...l/news-story/93e7656da0cff4fc4d2c5e51706accb5

If this report is accurate it could turn out to be huge.

 

[Another Reader]

If this report is accurate it could turn out to be huge.

Would have been nice if they had named the drugs... probably a combination of chloroquine and one of the anti-retrovirus HIV drugs.

 

[MichaelB]

Would have been nice if they had named the drugs... probably a combination of chloroquine and one of the anti-retrovirus HIV drugs.

From the article

One of the two medications is a HIV drug, which has been superseded by “newer generation” HIV drugs, and the other is an anti-malaria drug called chloroquine which is rarely used and “kept on the shelf now” due to resistance to malaria.

 

[JoeWras]

Would have been nice if they had named the drugs... probably a combination of chloroquine and one of the anti-retrovirus HIV drugs.

Scroll down, they name them. I think you nailed it.

 

[candrew]

My apologies if this has already been posted.

This is the report that prompted yesterday's White House press conference: https://www.imperial.ac.uk/media/im...-College-COVID19-NPI-modelling-16-03-2020.pdf

A scientific report compiled by British researchers and shared with the White House warns that, in the absence of drastic and coordinated government action, the novel coronavirus could kill as many as 2.2 million people in the United States alone.

The new research, led by epidemiologist Dr. Neil Ferguson and published Monday by the Imperial College of London, shows that merely acting to slow rather than completely stop the spread of COVID-19 would "still likely result in hundreds of thousands of deaths and health systems (most notably intensive care units) being overwhelmed many times over."

"For countries able to achieve it, this leaves suppression as the preferred policy option," the researchers wrote. "In the U.K. and U.S. context, suppression will minimally require a combination of social distancing of the entire population, home isolation of cases, and household quarantine of their family members. This may need to be supplemented by school and university closures."

Successful suppression of the virus could take a significant amount of time, the researchers noted—"potentially 18 months or more."

 

[ERD50]

You seem to be saying that closing school and keeping kids home makes them more exposed to infection, leading to more overall infections. Is this your point? If so, we disagree, as it goes against all the reasoning behind avoiding crowds, close contact, etc.

If that's all there was to it (keeping kids home would limit exposure), sure.

But that's not all there is to it, there is reasoning behind it, as I and others have said (you are sticking to static models again).

I already covered it, kids will be going to Park District programs for example, how do they get there, (a different group of adults than just the routine bus driver, maybe a different parent takes a group of kids?)? Then they interact with a different group of kids at the program. And there might be several different programs for different interests. Each program could be a different group of kids. So instead of seeing the same classmates everyday, maybe they end up interacting with a much larger group of kids and adults.

And despite the warnings to not have elderly people watch the kids, it's going to happen. And if kids get together at a friend's home to play (they will, some at-home parents will volunteer), those kids are in close contact, and now add an adult or two that the kids would not have had direct contact with. And maybe different parents on different days to spread the "pain"?

I can't say definitively that this will be worse on average, but I don't see how you can be so sure that it won't be worse. There are many, many cases of "unintended consequences", and this every well may be another. Sounds good on the surface, but may may things worse.

-ERD50