COVID COVID-19 Coronavirus Containment Efforts

[russ_watters]

A chart explaining why the number of confirmed cases in the US likely greatly underestimates the actual number of cases (and how countries like South Korea have been more effective in managing the outbreak and keeping death rates low):
View attachment 258643
https://www.vox.com/platform/amp/sc.../12/21175034/coronavirus-covid-19-testing-usa

A note of caution* about media-created graphics: The news media excels at creating pretty graphics, but is quite poor at epidemiology and scientific analysis of information in general. So such information should be read with a skeptical eye, not taken at face value. This one has issues and is hard to digest.

The US has certainly bungled the availability of testing, but that graphic -- arranged in what at first glance looks intended to be a worst-to-first order is a "today" (roughly) snapshot that doesn't take into account where the different countries are in the progression of the disease. Quite obviously as the disease spreads throughout a population, more and more people will be tested. For example, the US is something like 10 days behind Italy in terms of absolute numbers infected, and much further than that in per-capita. And while the province of China where the disease originated ranks "second best", that's only because the disease took hold there something like 2 months before anywhere else. I'm sure we've all seen the story about how a doctor trying to raise awareness of the new disease was arrested on Jan 1.

*mostly for others, as I know you have some expertise here...

 

[russ_watters]

My main thing I'm trying to figure out is if I feel really ill, but still lucid and able to drive, would it be better to drive myself to an E.R. if things get bad over calling an ambulance?

If I'm not mistaken, calling 911 for an ambulance can cost thousands?

Call your doctor and ask. If you can't reach them, call your nearest hospital and ask. Do not just show up in the emergency room.

When you say "an ambulance can cost thousands", I assume that means you are uninsured (also as per a previous thread)? If you can still drive, the hospital may direct you to an outside-the-hospital triage area or just meet you in the parking lot.

Also, while it hasn't been decided yet, it is possible if not likely that the US government will be reimbursing uninsured people for Coronavirus related medical costs:
https://www.marketwatch.com/story/p...edical-bills-for-coronavirus-tests-2020-03-10

 

[russ_watters]

I wonder what the plots we're looking at really mean? Is it more about the dynamics of testing kit production, and testing restrictions? That in combination with non-community spread?

I mean, suppose half the population had it from the start, then what would the evolution of confirmed cases look like?

Who is she? It is likely that many more people have it than is known, but with positive test rates in the single digits in most places, it doesn't seem possible for 1% to already be infected. Ohio has 15 confirmed cases in a population of 11.7 million, 65 tests complete and another 159 pending. But we'll know in a week if she was right!

https://www.worldometers.info/coronavirus/covid-19-testing/
https://www.cnn.com/2020/03/03/health/us-coronavirus-cases-state-by-state/index.html
https://www.whio.com/news/local/cor...-you-need-know-friday/YpjSqWSijaqILGuNnR7LVO/

 

[Vanadium 50]

arranged in what at first glance looks intended to be a worst-to-first order is a "today" (roughly) snapshot that doesn't take into account where the different countries are in the progression of the disease.

Exactly.

First, the Voxsplainers have an axe to grind in general.

Second, cases per million (currently about 6 for the US) shows a different story - as you say, the US is in an earlier phase of the epidemiology. The most similar in that regard is Japan, the second "worst". However, Japan also has the highest elderly dependency ratio in the world - 48%! That's twice the US's 24%. Given that this is fatal primarily to the elderly, the relative rsponses of the two countries are more similar than the raw numbers indicate. (Indeed, I think the elderly population is a more relevant number than total population in this regard)

 

[StevieTNZ]

NZ has its sixth confirmed case. https://www.stuff.co.nz/national/he...rus-waitemat-dhb-chief-provides-a-live-update

Also a MP of ours is being tested after being around Australia MP Peter Dutton who has been confirmed as having the virus. https://www.stuff.co.nz/national/he...ected-aussie-mp-in-the-white-house-a-week-ago

And tomorrow's remembrance event for the terror attack last year has been canned -- https://www.stuff.co.nz/national/ch...-15-terror-attack-remembrance-event-cancelled

 

[chirhone]

In just one week. Our positives have increased from 3 to an incredible 64! Tonight the Lockdown will begin. I am expecting to see this in tv:

"This is not a test. This is your emergency broadcast system announcing the commencement of the Lockdown, sanctioned by the government. Workers outside have been authorized to enter during the Lockdown. All other people are restricted. Government officials of high ranking have been granted immunity from the Lockdown and shall not be arrested. Commencing at the siren, any and all mass garhering, including wedding parties will be illegal for 1 continuous month. Police, fire, and emergency medical services will always be available. Blessed be our New Founding Fathers and America, a nation reborn. May God be with you all."

I imagine the sirens blare across the capital, and the Lockdown begins.

 

[Klystron]

Question for the thread concerning re-infection. Realizing data remains incomplete, do we have any reliable information on Covid-19 survivors becoming reinfected or reinfecting themselves?

This likely involves how and if recovered patients develop antibodies and immunity to the pathogen. Thanks.

 

[WWGD]

I wonder what the plots we're looking at really mean? Is it more about the dynamics of testing kit production, and testing restrictions? That in combination with non-community spread?

I mean, suppose half the population had it from the start, then what would the evolution of confirmed cases look like?

What's special about Ohio? Why is it being brought up by so many?

 

[atyy]

Who is she? It is likely that many more people have it than is known, but with positive test rates in the single digits in most places, it doesn't seem possible for 1% to already be infected. Ohio has 15 confirmed cases in a population of 11.7 million, 65 tests complete and another 159 pending. But we'll know in a week if she was right!

https://www.worldometers.info/coronavirus/covid-19-testing/
https://www.cnn.com/2020/03/03/health/us-coronavirus-cases-state-by-state/index.html
https://www.whio.com/news/local/cor...-you-need-know-friday/YpjSqWSijaqILGuNnR7LVO/

"I very respectfully disagree with the estimate of 100k #COVID19 infections in Ohio put forth by the @OHdeptofhealth. As far as I can ascertain from the press coverage (https://news5cleveland.com/news/con...says-100-000-ohioans-are-carrying-coronavirus), this number comes from extrapolating from 2 community cases detected."

Trevor Bedford is an Associate Member at the Fred Hutch in the https://www.fredhutch.org/en/labs/vaccine-and-infectious-disease.html and the https://www.fredhutch.org/en/labs/phs/projects/herbold-computational-biology-program.html. He is also an Affiliate Associate Professor in the Department of Genome Sciences and the Department of Epidemiology at the University of Washington.

 

[Vanadium 50]

What's special about Ohio?

Because of the press conference, where based on 14 cases (and zero deaths, so I can't say "four dead in Ohio"), they inferred 100,000 people infected. That's newsworthy.

 

[phinds]

If I'm not mistaken, calling 911 for am ambulance can cost thousands?

My son had to use an ambulance and after his insurance paid whatever IT paid, he was stuck with a bill for $1,500 and I've heard of worse. Check with your insurance company.

 

[kadiot]

In just one week. Our positives have increased from 3 to an incredible 64! Tonight the Lockdown will begin.

Yesterdat lots of people fleeing Metro Manila. Looks like it defeats the purpose of a "community quarantine" (a.k.a. lockdown). President Duterte should have declared it effective immediately. Looks like the people were given enough to bring the virus to different provinces.

 

[Evo]

Yesterdat lots of people fleeing Metro Manila. Looks like it defeats the purpose of a "community quarantine" (a.k.a. lockdown). President Duterte should have declared it effective immediately. Looks like the people were given enough to bring the virus to different provinces.

That's not good.

 

[StevieTNZ]

Our PM has announced that anyone arriving from overseas, from Sunday midnight, will be required to self-isolate for 14 days.

https://www.stuff.co.nz/national/he...prime-minister-updates-nz-on-covid19-outbreak

 

[chirhone]

Yesterdat lots of people fleeing Metro Manila. Looks like it defeats the purpose of a "community quarantine" (a.k.a. lockdown). President Duterte should have declared it effective immediately. Looks like the people were given enough to bring the virus to different provinces.

Today March 14, the last day before the lockdown. There are even greater lineups at the bus terminals for those escaping the lockdown. I even know some rushing to get out of the city. The fear is lack of food as the groceries are near empty now. The rich or those who can afford are stocking up. The poor can't stock anything. So there may be trouble in days ahead.

https://news.mb.com.ph/2020/03/13/p...ces-or-back-to-manila-before-lockdown-starts/

Also during the lockdown itself. People or workers from provinces can still get in and out of the lockdown daily, if they have company identification cards to show to police checkpoints (they enter lockdown at morning, get out at night, then back daily). I don't know what would happen if the people getting out of the lockdown has virus. They can spread it to other cities outside the zone.

https://www.pna.gov.ph/articles/1096493

Note the above is about workers getting in and out of the lockdown zone daily.

In Italy. I heard it was now so spread with over 10,000 positives because before the lockdown of the north. There was leak of it, and people ran to the south, and spread the virus to the entire country. Now Italy is suffering. Hope the outcome here is better. The hope is that those in exodus outside the lockdown yesterday and today don't carry the virus.

 

[mfb]

Do you have a reliable source for this?

https://www.dailymail.co.uk/news/ar...-Donald-Trumps-hand-POSITIVE-coronavirus.html

Dailymail is a tabloid and the exact opposite of a reliable source.

 

[kadiot]

Today March 14, the last day before the lockdown. There are even greater lineups at the bus terminals for those escaping the lockdown. I even know some rushing to get out of the city. The fear is lack of food as the groceries are near empty now. The rich or those who can afford are stocking up. The poor can't stock anything. So there may be trouble in days ahead.

https://news.mb.com.ph/2020/03/13/p...ces-or-back-to-manila-before-lockdown-starts/

Also during the lockdown itself. People or workers from provinces can still get in and out of the lockdown daily, if they have company identification cards to show to police checkpoints (they enter lockdown at morning, get out at night, then back daily). I don't know what would happen if the people getting out of the lockdown has virus. They can spread it to other cities outside the zone.

https://www.pna.gov.ph/articles/1096493

Note the above is about workers getting in and out of the lockdown zone daily.

In Italy. I heard it was now so spread with over 10,000 positives because before the lockdown of the north. There was leak of it, and people ran to the south, and spread the virus to the entire country. Now Italy is suffering. Hope the outcome here is better. The hope is that those in exodus outside the lockdown yesterday and today don't carry the virus.

Key points from President Duterte's press conference:

1. Provincial quarantine if more than 2 positive COVID-19 cases

2. Work in executive dept. is suspended, except for skeletal staff

3. Flexble work arrangement encouraged in private sector. Manufacturing and retail businesses encouraged to stay open with social distancing and minimal work force

4. Mass public transport shall continue operation with social distancing

5. Domestic air, sea and land transport suspended from March 15, 2020 (12 midnight) to April 14, 2020, subject to the review of inter-agency task force.

6. Code alert is now raised to Sublevel 2, highest level

7. Stringent social distancing measures in NCR for 30 days

8. Suspension of classes in all levels in Metro Manila until April 12, 2020. Stay at home and study

9. Mass gatherings, either planned or spontaneous,...shall be prohibited during this period. If social distancing is no longer obeyed, if rules are disobeyed, this is punishable under the penal code and can be arrested by military and police

10. Community quarantine is hereby imposed in the entire of Metro Manila

11. In other areas, LGUs can impose localized quarantine

12. Baranggay-wide quarantine is advised if there are 2 or more COVID-19 cases

13. Municipality or city wide quarantine advised if 2 positive COVID-19 cases or more

14. Not enough military and police to cover the whole country. Barangay Captain is the police. Bgy. Captain can also go to prison if they don't enforce these regulations.

15. Close monitoring and reassessment of these regulations after 7 days from today

16. LGUs outside NCR advised to exercise sound discretion to suspend classes, but does not allow you to suspend classes for trivial reasons

17. PNP and AFP shall be called upon for effective and orderly implementation of above measures. This is not martial law. Do not be afraid of the PNP and AFP. They are there to help you.

18. Daily meetings of Inter Agency Task Force (IATF) and all relevant agencies

19. In social disturbance, military will keep order

20. OFWs allowed to travel to Mainland China except to Hubei

21. If things detrioriate, we may have to ask for China's help

22. Entry travel restriction imposed to all countries with COVID-19 cases, exept for Filipinos and their families, permanent visa holders and diplomats

23. Purpose of this is to protect and defend you from COVID-19

24. AFP and PNP will maintain peace and order. Just follow.

25. Our COVID-19 cases relatively low but fast to rise. You will be asked to go to the hospital and seek treatment.

26. COVID-19 tests are free

27. I ask for your patience. Help each other. Everything is placed in jeopardy.

 

[kadiot]

Sorry this is taken from a tabloid again. Fact-check, please.

---

The lack of widespread testing for the Coronavirus is “a failing” of the U.S. public health system, the government’s top infectious disease scientists told lawmakers, even as the nation’s surgeon general said separately that not everyone needs to get tested. “The system is not really geared to what we need right now -- what you’re asking for -- that is a failing,” said Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases. “It is a failing. Let’s admit it.”

https://www.bloomberg.com/news/arti...-is-unable-to-handle-large-volume-virus-tests

 

[kadiot]

Scientists have now shown that the angiotensin-converting enzyme 2 (#ACE2) receptor serves as the binding site for SARSCoV2, the Coronavirus implicated in the current #COVID19 outbreak.

The outbreak only began late December / early January but within a short period of time, scientist have come up with information that traditionally takes much longer. ScienceMatters

Since this landmark study was published, some have suggested that angiotensin receptor blockers (ARBs) like Losartan can prevent COVID-2019 infection. It’s important to remember that ACE inhibitors and ARBs DO NOT ACT on this receptor directly, so they are not going to affect the activity of the #virus for these cells. The proposed interactions of ACE inhibitors and ARBs with the virus is purely HYPOTHETICAL with no reliable data to justify any deviation from current practice guidelines.

This practice, besides being useless to prevent COVID-2019 infection, may be harmful, leading to inappropriate drug treatments and risk of adverse events, or may instill dangerous over-confidence against the infection risk.

Patients should continue to receive these medications if indicated for their cardiovascular condition. There is no evidence for extra benefit or extra harm in these patients.

 

[mfb]

22. Entry travel restriction imposed to all countries with COVID-19 cases, exept for Filipinos and their families, permanent visa holders and diplomats

Do you have an article about this? Would be useful for Wikipedia's list.

 

[kadiot]

Do you have an article about this? Would be useful for Wikipedia's list.

Here is the Memorandum from the Executive Secretary

 

[kadiot]

When Canada’s leader Trudeau was asked if he would seal the border between Canada and US, he answered;
“NOT YET TIME...”

Italy’s leader, Conte, also said a similar response... until... 1,000 died of Covid-19 and now he has now finally declared the lockdown of the entire country...

Lessons to be learned by other leaders? Maybe ...

 

[bhobba]

A chart explaining why the number of confirmed cases in the US likely greatly underestimates the actual number of cases (and how countries like South Korea have been more effective in managing the outbreak and keeping death rates low)

This is what gets me. We know what works:
https://www.nytimes.com/2020/03/13/opinion/coronavirus-best-response.html

Just do it. First - new breakthrough:
https://kdvr.com/news/coronavirus/e...an-get-covid-19-test-results-in-2-10-minutes/

A complete lock-down of the country like NZ has done will likely work:
https://www.stuff.co.nz/national/he...prime-minister-updates-nz-on-covid19-outbreak

Australia where I live could do the same. But will it work any better than test, test, then test some more? Test everyone coming in, have roving teams going around testing everyone on the streets - ensure people that need to quarantine actually do. Trace infected individuals thoroughly. Do social distancing measures - great, wash your hand s etc - well really you should do that anyway just to reduce the cases of flu and the common cold - reinforce it - yes - but a complete lock down?

Thanks
Bill

 

[bhobba]

If I'm not mistaken, calling 911 for am ambulance can cost thousands?

That depends on where you live. In Australia, its free in many (but not all) states, paid for in various ways depending on the state you live in by a levy on something eg electricity bills. Otherwise its always part of any medical insurance you have. But in places that do not have that its reached farcical proportions. Everyone is told in an emergency you ring 000 (I think 911 works here as well). You are then asked - police, fire or ambulance. Woe is you if you say ambulance, because you have to pay the bill which here, just to get them out, not including anything else they might do, costs about $1000.00. One good Samaritan is still being chased by debt collectors for calling the ambulance when he saw a car accident. Amazing.

But as to your question - ring emergency and say police - they should get you to hospital without cost - this is your life we are talking about.

Thanks
Bill

 

[wukunlin]

A complete lock-down of the country like NZ has done will likely work:
https://www.stuff.co.nz/national/he...prime-minister-updates-nz-on-covid19-outbreak

Australia where I live could do the same. But will it work any better than test, test, then test some more? Test everyone coming in, have roving teams going around testing everyone on the streets - ensure people that need to quarantine actually do. Trace infected individuals thoroughly. Do social distancing measures - great, wash your hand s etc - well really you should do that anyway just to reduce the cases of flu and the common cold - reinforce it - yes - but a complete lock down?

Thanks
Bill

NZ is just having people quarantined, unlike how in China where some cities are disallowing everyone from entering or leaving, except for supply runs and medical teams. I'm not sure how the quarentine will be implemented in NZ. During SARS, people from danger zones just had to stay at home for 14 days with no way to tell if they actually did that.

China had to be draconian because a lot of people in surburban regions are still lacking that public health awareness. It was difficult to make them understand just how serious this is, especially when visiting relatives during the Chinese New Year was a very important practice. Some were successful through hefty bonuses to village council leaders if they can keep their regions disease free, which lead to loud speakers telling people to stay at home and even trenches and roadblocks sealing up these villages.

 

[hagopbul]

Yes, I have a primary care doctor.

I am also self-iso-ing.

I also do not have work for at least a couple of weeks. So, this is all-aroudn good.

My main thing I'm trying to figure out is if I feel really ill, but still lucid and able to drive, would it be better to drive myself to an E.R. if things get bad over calling an ambulance?

If I'm not mistaken, calling 911 for am ambulance can cost thousands?

Please do not panic

But why on Earth an ambulance will cost you money , if you don't have money or you are not insured they won't come take you .

Seriously they ask money from you or from some the insurance company ?!?

I don't live in the US so I don't know how your medical system work

But just do not panic and take care of yourself

 

[bhobba]

But why on Earth an ambulance will cost you money , if you don't have money or you are not insured they won't come take you .

Of course do not panic - that's the worst thing you can do.

I do not know how it is in other countries, but here in Aus, you ring the ambulance (or rather emergency and ask for an ambulance) then they come. They will if necessary chase you for money later. Until recently most people in Aus had some form of medical insurance, and in some places its free so was not a big issue - but still an issue. Recently people have been deciding they are sick and tired of insurance due to its very fast rising cost, and the sneaky tricks insurance companies/private hospitals use so you keep getting bills that trickle in for months after. You go to a public hospital - no charge at all. So people are leaving in droves. Basic actuarial science - less people to spread risk - up goes your premiums, which causes more to leave and you have a death spiral. Anyway we now have a lot less insured and the chasing of ambulance bills is fast becoming a big issue.

All this is of course solvable, but the exact method depends on your philosophical inclination, those more on the personal responsibility spectrum will want a different resolution than those more on the collectivist spectrum, so it gets grid locked in politics.

Thanks
Bill

 

[pinball1970]

A study as to whether it's air borne. Pre print

https://www.medrxiv.org/content/10.1101/2020.03.09.20033217v2

 

[atyy]

Doctor called Corona helps Indonesia battle coronavirus
https://www.thestar.com.my/news/reg...led-corona-helps-indonesia-battle-coronavirus

 

[kyphysics]

But as to your question - ring emergency and say police - they should get you to hospital without cost - this is your life we are talking about.

Possibly, but they could also call for an ambulance to take me, esp. if they think I have coronavirus, lol. They wouldn't want to come to my house and get infected.

I will definitely get to an E.R. one way or another. For sure, not playing around with my life or LUNGS:

https://www.yahoo.com/news/people-fully-recover-coronavirus-left-103917303.html
People who fully recover from the Coronavirus can be left with '20 to 30%' less lung function, and gasping for breath when they walk quickly, Hong Kong doctors find