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Formerly DT: COVID-19 - Featuring Lots of Politics, now CR because political talk not going away


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7 minutes ago, Neonmoon said:

I know this is a CR issue, but I was wondering why the "Flu kills more people" keeps getting pushed by the uninformed? I don't get it. 

1 in 25 vs 1 in 1000

I wish there was an information sheet showing why that yes, currently, the Flu has killed more people this year, but it's because we don't contain people for the flu, we have a vaccination for the Flu, etc. etc. 

I think we still don’t know what the mortality rate is for covid-19 (and maybe I’m misreading your post - it’s not 1/25). 
 

What’s clear is that it’s highly infectious and like other coronovirus can survive in droplets well. Most concerning, it’s the number of people put in respiratory distress and in need of hospitalization. That and the impact for the elderly and those with pre-existing issues. 

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1 minute ago, Txzen said:

I think we still don’t know what the mortality rate is for covid-19 (and maybe I’m misreading your post - it’s not 1/25). 
What’s clear is that it’s highly infectious and like other coronovirus can survive in droplets well. Most concerning, it’s the number of people put in respiratory distress and in need of hospitalization. That and the impact for the elderly and those with pre-existing issues. 

Yeah, at the end of the day, it’s the number of people it hospitalized, and the 2-3 weeks of their hospital stay that is the concerning factor.   That’s going to put a huge strain on a lot of things, whether it’s the healthcare system itself, or the ripple effects like the economy.

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1 hour ago, 4th&Five said:

Y’all are pussies. I leave for Tokyo on 3/14. 

Unfortunately, I am in the dead pool also. But it is hard to place on order on which on of our posters will be the first to be stricken. Raydog took the early lead. Then there was the guy posting from Singapore. Armybrat, just because. A few docs and people ordering from Panda Express. And then there is you.

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3 minutes ago, Txzen said:

I think we still don’t know what the mortality rate is for covid-19 (and maybe I’m misreading your post - it’s not 1/25). 
 

What’s clear is that it’s highly infectious and like other coronovirus can survive in droplets well. Most concerning, it’s the number of people put in respiratory distress and in need of hospitalization. That and the impact for the elderly and those with pre-existing issues. 

I believe scientists have come out saying the Flu kills 1 in 1000 while Covid-19 kills 1 in 25

Yes, I believe the mortality is still a moving target for Covid-19, but that was the comparison given

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6 minutes ago, Neonmoon said:

I know this is a CR issue, but I was wondering why the "Flu kills more people" keeps getting pushed by the uninformed? I don't get it. 

1 in 25 vs 1 in 1000

I wish there was an information sheet showing why that yes, currently, the Flu has killed more people this year, but it's because we don't contain people for the flu, we have a vaccination for the Flu, etc. etc. 

1 in 25? That is not a accurate number, that would be 4%. Most think (including WHO) have this sub 1%  and it will keep falling as they test people with more mild symptoms. 

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2 minutes ago, Bevo said:

Unfortunately, I am in the dead pool also. But it is hard to place on order on which on of our posters will be the first to be stricken. Raydog took the early lead. Then there was the guy posting from Singapore. Armybrat, just because. A few docs and people ordering from Panda Express. And then there is you.

😷

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I find it fascinating that people are reporting no work travel restrictions. 
 

My company informed us at the outset we were forbidden to travel to Asia, and if we were headed back we would have to self-quarantine for 14 days. Now, several weeks later, we’re being asked to curtail all non-essential travel - even domestic. I should say my employer is a large drug company, one which is testing existing agents on this bug in trials as we speak. 

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Just now, Txzen said:

I think we still don’t know what the mortality rate is for covid-19 (and maybe I’m misreading your post - it’s not 1/25). 
 

What’s clear is that it’s highly infectious and like other coronovirus can survive in droplets well. Most concerning, it’s the number of people put in respiratory distress and in need of hospitalization. That and the impact for the elderly and those with pre-existing issues. 

well said

in addition to the need for hospitalization which makes it much worse there is also the issue with how long someone can be a carrier of the virus both before and after they show symptoms

with the before part being what I feel is the most dangerous aspect......you can apparently be walking around for a week to 10 days or more with the virus and not be showing symptoms while spreading it to others and of course after showing symptoms you can be spreading it for at least 14 days (looking like possibly much longer now)

both of those time frames are much longer than the flu

so you can be going around feeling just fine for about a week or more while spreading it to thousands of people and then if you just feel "like I have the flu" (as some do) and you still go out and about you can be spreading it to others for 14 days or more.....and many of those people will need more than just chicken soup and bed rest they will need hospitalization and quarantine and a lot of "might work" drugs

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19 minutes ago, Neonmoon said:

I know this is a CR issue, but I was wondering why the "Flu kills more people" keeps getting pushed by the uninformed? I don't get it. 

1 in 25 vs 1 in 1000

I wish there was an information sheet showing why that yes, currently, the Flu has killed more people this year, but it's because we don't contain people for the flu, we have a vaccination for the Flu, etc. etc. 

 

4 minutes ago, Neonmoon said:

I believe scientists have come out saying the Flu kills 1 in 1000 while Covid-19 kills 1 in 25

Yes, I believe the mortality is still a moving target for Covid-19, but that was the comparison given

Well you answered your own question on why misinformation keeps being pushed by the "uninformed". 

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3 minutes ago, Txzen said:

I find it fascinating that people are reporting no work travel restrictions. 
 

My company informed us at the outset we were forbidden to travel to Asia, and if we were headed back we would have to self-quarantine for 14 days. Now, several weeks later, we’re being asked to curtail all non-essential travel - even domestic. I should say my employer is a large drug company, one which is testing existing agents on this bug in trials as we speak. 

You'd think they'd relish having more human subjects instead of cancelling travel. 

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In a normal year, thousands of Asians and hundreds of thousands of people use my town as a way station at the beginning or end of their Yellowstone trips, starting in late May. 
 

the town has a high % of retirees, so older. I don’t need this virus sweeping through killing off a few hundred olds and cratering my house value from market saturation. 
 

so what kind of daytime temps are we talking about to knock this back?

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28 minutes ago, Neonmoon said:

I know this is a CR issue, but I was wondering why the "Flu kills more people" keeps getting pushed by the uninformed? I don't get it. 

1 in 25 vs 1 in 1000

I wish there was an information sheet showing why that yes, currently, the Flu has killed more people this year, but it's because we don't contain people for the flu, we have a vaccination for the Flu, etc. etc. 

Because the flu does kill more people?

Are you talking about case rate fatality (CRF) or overall deaths? 

I think the flu does kill more people. I could be wrong, though. 

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1 minute ago, Pato del Muerto said:

In a normal year, thousands of Asians and hundreds of thousands of people use my town as a way station at the beginning or end of their Yellowstone trips, starting in late May. 
 

the town has a high % of retirees, so older. I don’t need this virus sweeping through killing off a few hundred olds and cratering my house value from market saturation. 
 

so what kind of daytime temps are we talking about to knock this back?

Typically mid to high 70s is enough

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12 minutes ago, Updawg said:
36 minutes ago, atomheartbevo said:
Pro tip: If your HEB runs out, your closets Randall’s and Kroger’s will still be pretty stocked.  

Randall's has early voting this week so some voters are actually shopping there. But next week it will be back to empty.

10% off with your voting sticker?  Still 15% higher than HEB.  

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2 minutes ago, Pato del Muerto said:

In a normal year, thousands of Asians and hundreds of thousands of people use my town as a way station at the beginning or end of their Yellowstone trips, starting in late May. 
 

the town has a high % of retirees, so older. I don’t need this virus sweeping through killing off a few hundred olds and cratering my house value from market saturation. 
 

so what kind of daytime temps are we talking about to knock this back?

Get out and fire up your SUV.

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Diamond Princess by the numbers as of 2/28 (so about 10 days after most released):

691 of 3700 passengers confirmed: 19%

328 of 691 asymptomatic: 47%

6 of 691 dead: 0.87% cfr or 1.6% of symptomatic cases

We will see how many more deaths of that 691/328. I would he surprised if it goes more than 12. But we are still in the "oh fuck I'm dead" window. Those numbers exist within an environment pretty excellent medical care (no shortages of ICU intervention) but a uniquely old skewing population. 

Preliminary lessons:

• So "only" 20% got it in atypically bad environment, though there was really on 1 or 2 weeks of transmission. Not sure if that is a good or bad fact for the rest of the world. 

• About half the cases were asymptomatic. 

• Death rate likely no worse than maybe 1% - though you could totally make a more severe interpretation.  I figure the old age of the passengers is offset by the number of asymptomatic cases. A normal population would be healthier but we wouldn't catch the mild cases so the denominator would be illusory. 

One I interesting thing I read about SARS that it is under reported is how many of the survivors are basically on disability the rest of their lives. They didn't die, but many had permanent lung damage. That would suck.

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1 minute ago, Armybrat said:

We are driving over to Taylor in a few minutes to have lunch at Mas Fajitas with some of Mrs. Brat’s high school classmates (Fightin’ Taylor Ducks - Class of 1963). Hen party with a couple of retired farmers/aggy.

Any survival tips welcome.

 

Avoid the aggys?

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Just now, Asithappens said:

Because the flu does kill more people?

Are you talking about case rate fatality (CRF) or overall deaths? 

I think the flu does kill more people. I could be wrong, though. 

This flu talk actually brings up what is probably my number one medical related pet peeve. I absolutely cannot fucking stand every dumb ass American asshole who gets a cold and says they have "the flu". It drives me batshit ass crazy. You do not have the flu motherfucker. The flu is serious shit and legit can kill you.

 

Fuck.

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5 minutes ago, Pato del Muerto said:

In a normal year, thousands of Asians and hundreds of thousands of people use my town as a way station at the beginning or end of their Yellowstone trips, starting in late May. 
 

the town has a high % of retirees, so older. I don’t need this virus sweeping through killing off a few hundred olds and cratering my house value from market saturation. 
 

so what kind of daytime temps are we talking about to knock this back?

Don't worry, once the caldera erupts, the virus will most certainly be gone.  

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43 minutes ago, atomheartbevo said:

Pro tip: If your HEB runs out, your closets Randall’s and Kroger’s will still be pretty stocked.  

La Hacienda marts are also an excellent option, but I wouldn't buy any meat there. My dog wouldn't eat the raw turkey quarter I got from Poco Loco. She sniffed that shit then looked at me like I was trying to kill her. 

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5 minutes ago, Asithappens said:

Were all going to be exposed to this. Stop the pollyanna thinking that you can protect yourself from exposure to the virus. 

Accept it. Embrace it. Pray to whatever god you want. My god is Stevie Ray Vaughan and he even has his own statue. 

[Kobe]Stay out of helicopters[/Bryant]

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2 minutes ago, Asithappens said:

Were all going to be exposed to this. Stop the pollyanna thinking that you can protect yourself from exposure to the virus. 

Accept it. Embrace it. Pray to whatever god you want. My god is Stevie Ray Vaughan and he even has his own statue. 

Just because you're not opening up your notebook of potential future spouses (PFS), and reaching out to them to see how things are going, if they've moved, if they've married/remarried/divorced, doesn't mean the rest of us haven't.  I mean, the chances of my wife catching it are slightly higher than most (she's works in education), but she's relatively young and is very healthy and has a helluva an immune system, so that bodes well for recovery.  But it's always a good idea to be prepared.

Speaking of, one of the ladies in my PFS pool is 5 foot tall.  Out of Raydog territory by only 2 inches.

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40 minutes ago, hornbri said:

1 in 25? That is not a accurate number, that would be 4%. Most think (including WHO) have this sub 1%  and it will keep falling as they test people with more mild symptoms. 

Seriously.  What "scientist" is speculating 4%.  There is nothing to support that.  Look at how many on the cruise ship were confirmed but "asymptomatic".  In the real world virtually none of those people will never be on the confirmed list so will never be counted in the denominator for a mortality analysis.   The reality is the world is currently only testing a tiny percentage of symptomatic cases. Reminder, in the US, we won't be testing at scale for at least another week and then results will still lag by several days.  And obviously the vast majority of those tested in the first few weeks are going to be on the severe side.  How long until you and I can go to the doctor with a mild fever and get tested is anybody's guess but not in the near term.

So Neon may say people comparing it to the Flu are "uninformed" but I would say anyone claiming this is "likely" 4% mortality is also uninformed.  We probably won't actually know where this sits on the spectrum from no big deal to "we're fucked" for 2-3 months at least.  There simply isn't enough data.

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I actually think this is going to be way worse than most are predicting. I think 3/4 of the US is likely to catch it, with 7-15% of those who caught it being severe cases. Thats roughly 15-30 million people who will want to be/have to behospitalized. We only have 100,000 icu beds in the entire country

 

you bout to see the most epic re-purposing/healthcare mash unit this world has ever seen. Every surgery center, every hospital, every place that has an oxygen outlet... occupied. And stays will likely be 2-4 weeks. 
 

this world as we know it now bout to be shut down for a while. 

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1 hour ago, VABuckeye said:

Copied from a post by a doctor on a thread on another forum.

He raises a good point about only the sickest being tested in other countries.  South Korea mortalilty rate dropping daily is a very good indicater.  

ETA: He meant that South Korea peaked at just under 1.0% mortality rate.

Except we won't know for awhile what the secondary infection death rates are.  And deaths from other causes after recovery/ies that were hastened by the weakening from China Flu.  And deaths from even more rounds of China Flu infections as the years go on.  Etc.

It should evolve into less deadly strains, but what if it takes more than a year?  Doesn't go dormant during the summer?  Still potent in 2021, 2022?  In theory 1% for the first infection, maybe 3% for secondary infections and other indirect causes hastened by weakening, ? for third/fourth/fifth infections? 

I'm certainly not predicting anything like that, it's unlikely, but we don't know yet what the compounded rate could be.  1% now might end up 5%+ for premature deaths over the next few years. 

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I actually think this is going to be way worse than most are predicting. I think 3/4 of the US is likely to catch it, with 7-15% of those who caught it being severe cases. Thats roughly 15-30 million people who will want to be/have to behospitalized. We only have 100,000 icu beds in the entire country
 
you bout to see the most epic re-purposing/healthcare mash unit this world has ever seen. Every surgery center, every hospital, every place that has an oxygen outlet... occupied. And stays will likely be 2-4 weeks. 
 
this world as we know it now bout to be shut down for a while. 
Ballgame
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Why Some COVID-19 Cases Are Worse than Others

Emerging data as well as knowledge from the SARS and MERS coronavirus outbreaks yield some clues as to why SARS-CoV-2 affects some people worse than others.

Katarina Zimmer
Feb 24, 2020

 

Like many other respiratory conditions, COVID-19—the disease caused by SARS-CoV-2—can vary widely among patients. The vast majority of confirmed cases are considered mild, involving mostly cold-like symptoms to mild pneumonia, according to the latest and largest set of data on the new coronavirus outbreak released February 17 by the Chinese Center for Disease Control and Prevention.   

Fourteen percent of confirmed cases have been “severe,” involving serious pneumonia and shortness of breath. Another 5 percent of patients confirmed to have the disease developed respiratory failure, septic shock, and/or multi-organ failure—what the agency calls “critical cases” potentially resulting in death. Roughly 2.3 percent of confirmed cases did result in death.  

Scientists are working to understand why some people suffer more from the virus than others. It is also unclear why the new coronavirus—like its cousins SARS and MERS—appears to be more deadly than other coronaviruses that regularly circulate among people each winter and typically cause cold symptoms. “I think it’s going to take a really, really long time to understand the mechanistic, biological basis of why some people get sicker than others,” says Angela Rasmussen, a virologist at Columbia University’s Mailman School of Public Health.  

In the meantime, the latest data from China and research on other coronaviruses provide some hints. 

Elderly and sick people are most susceptible to severe forms of COVID-19

The latest data from China stem from an analysis of nearly 45,000 confirmed cases, and on the whole suggest that the people most likely to develop severe forms of COVID-19 are those with pre-existing illnesses and the elderly.

While less than 1 percent of people who were otherwise healthy died from the disease, the fatality rate for people with cardiovascular disease was 10.5 percent. That figure was 7.3 percent for diabetes patients and around 6 percent for those with chronic respiratory disease, hypertension, or cancer. 

While overall, 2.3 percent of known cases proved fatal—which many experts say is likely an overestimate of the mortality rate, given that many mild cases might go undiagnosed—patients 80 years or older were most at risk, with 14.8 percent of them dying. Deaths occurred in every age group except in children under the age of nine, and, generally speaking, “we see relatively few cases among children,” World Health Organization Director General Tedros Adhanom Ghebreyesus said last week.

This pattern of increasing severity with age differs from that of some other viral outbreaks, notably the 1918 flu pandemic, for which mortality was high in young children and in people between 20 and 40 years of age. However, it’s broadly consistent with records of the SARS and MERS coronavirus outbreaks, notes Lisa Gralinski, a virologist at the University of North Carolina at Chapel Hill. “If you’re over fifty or sixty and you have some other health issues and if you’re unlucky enough to be exposed to this virus, it could be very bad,” she says. 

I think it’s going to take a really, really long time to understand the mechanistic, biological basis of why some people get sicker than others.

—Angela Rasmussen, Columbia University

Scientists don’t know what exactly happens in older age groups. But based on research on other respiratory viruses, experts theorize that whether a coronavirus infection takes a turn for the worse depends on a person’s immune response. “The virus matters, but the host response matters at least as much, and probably more,” says Stanley Perlman, a virologist and pediatric infectious disease specialist at the University of Iowa.

Once SARS-CoV-2 gets inside the human respiratory tract, it’s thought to infect and multiply in cells lining the airway, causing damage that kicks the immune system into action. In most people, it should trigger a wave of local inflammation, recruiting immune cells in the vicinity to eradicate the pathogen. The immune response then recedes, and patients recover. 

For reasons that aren’t entirely clear, some people—especially the elderly and sick—may have dysfunctional immune systems that fail to keep the response to particular pathogens in check. This could cause an uncontrolled immune response, triggering an overproduction of immune cells and their signaling molecules and leading to a cytokine storm often associated with a flood of immune cells into the lung. “That’s when you end up with a lot of these really severe inflammatory disease conditions like pneumonia, shortness of breath, inflammation of the airway, and so forth,” says Rasmussen. 

Local inflammation can turn into widespread inflammation of the lungs, which then has ripple effects across all organs of the body. This could also happen if the virus replicates faster than the immune system can respond, so that it then has to play catch-up to contain the pathogen—a situation that could also cause the immune defense to spiral out of control. “With mice, we know that in some cases, particularly for SARS and MERS coronaviruses, virus replication is very rapid and in some cases overwhelming” to the immune system, says Perlman.  

It’s harder to explain why young, healthy people also sometimes die from the disease—for instance, Li Wenliang, a 34-year-old doctor who first sounded the alarm about the virus. He died a few weeks after contracting the pathogen.

Genetic and environmental risk factors might help explain the severity of infections. Though it’s clear that genetic factors can strongly determine the outcome of viral infections in mice—as some of Rasmussen’s work has shown for Ebola, for instance—researchers haven’t yet been able to tease out specific genes or variants in mice, let alone in people, that are responsible for varying degrees of illness. Environmental factors, such as smoking or air quality, may also play a role in disease severity, Rasmussen adds.

A lot of research has gone into understanding what causes respiratory failure that results from systemic inflammation of the lungs—also called acute respiratory distress syndrome (ARDS)—that can occur from coronaviruses and other infections. Yet researchers still don’t know how it occurs exactly, let alone how to treat it, Gralinksi notes. “It’s still a really poorly understood issue.”  

Men might be more affected by COVID-19 than women

An intriguing finding in the new data released last week is that although similar numbers of men and women have contracted SARS-CoV-2, more men are dying from the disease. The death rate for males was 2.8 percent and 1.7 percent for women. Rasmussen is quick to caution that although the data encompass nearly 45,000 patients, “that’s still not that many people to determine if there’s really a gender bias—you’d have to look at this in a much larger population of patients in a number of different countries,” she says. 

That said, if there is a bias, it would be consistent with what epidemiologists have observed during the SARS and MERS outbreaks. In the 2003 SARS outbreak in Hong Kong, for instance, nearly 22 percent of infected men died, compared to around 13 percent of women. In an analysis of MERS infections between 2017 and 2018, around 32 percent of men died, and nearly 26 percent of women. The difference could have something to do with the fact that the gene for the ACE-2 receptor, which is used by both SARS-CoV-2 and the SARS virus to enter host cells, is found on the X chromosome, she speculates. If it’s a particular variant of the protein that makes people more susceptible to the virus, then females could compensate for that one bad variant because they’d have two copies of the X chromosome, whereas men would be stuck with only one copy. Or, “it could be that men are more likely to be smokers and so their lungs are already a bit compromised. There’s definitely more to be teased out there,” Gralinski says. 

Some of Perlman’s research, which demonstrated that the sex disparity also holds true in SARS-infected mice, points to the hormone estrogen as possibly having protective effects: Removing the ovaries of infected female mice or blocking the estrogen receptor made the animals more likely to die compared to infected control mice. The effects are probably more pronounced in mice than in people, Perlman tells The New York Times

Does an infection make people immune to the virus?

Whether patients develop antibodies after SARS-CoV-2 infection that will protect them against future infections is still a mystery. Surveys of SARS patients around five or 10 years after their recovery suggest that the coronavirus antibodies don’t persist for very long, Gralinski says. “They found either very low levels or no antibodies that were able to recognize SARS proteins.” 

However, for the new coronavirus, “we would expect some immunity, at least in the short term,” she says. 

Why different coronaviruses vary in severity

There are seven coronaviruses known to infect people. Four of them—229E, NL63, OC43, and HKU1—typically cause a cold and only rarely result in death. The other three—MERS-CoV, SARS-CoV, and the new SARS-CoV-2—have varying degrees of lethality. In the 2003 SARS outbreak, 10 percent of infected people died. Between 2012 and 2019, MERS killed 23 percent of infected people. Although the case fatality rate of COVID-19 is lower, the virus has already killed more people than the other two outbreaks combined, which some have attributed to the pathogen’s fast transmission.  

See “How COVID-19 is Spread”

The cold-causing coronaviruses, as well as many other viruses that cause common colds, are typically restricted to the upper respiratory tract, that is, the nose and sinuses. Both SARS-CoV and SARS-CoV-2, however, are capable of invading deep into the lungs, something that is associated with more severe disease.  

One possible reason for this is that the virus binds to the ACE-2 receptor on human cells in order to gain entry. This receptor is present in ciliated epithelial cells in the upper and lower airway, as well as in type II pneumocytes, which reside in the alveoli in the lower airway and produce lung-lubricating proteins. “The type II pneumocytes are . . . important for lung function, so this is part of why the lower respiratory disease can be so severe,” notes Gralinksi. 

The new coronavirus also appears to use the ACE-2 receptor, which may help partially explain why, like SARS, it is more deadly than the other four coronaviruses. Those pathogens use different receptors, except for NL63, which also uses the ACE-2 receptor but binds to it with less affinity, says Gralinski. (MERS is thought to use an entirely different receptor, which is also present in the lower airways.) 

Sustained interest required

To understand these questions fully will take time, research, and consistent funding for long-term studies. Coronavirus funding has been criticized for following a boom-and-bust cycle; viral spillovers from animals to people cause an initial surge of interest that tends to wane until the next outbreak occurs, Rasmussen warns. 

“I’m hopeful that in this case it will be really apparent to everybody in the world that we need to be funding this type of basic science, fundamental science, to understand these mechanisms of disease,” she says. “Otherwise, we’re going to be in the same situation when the next outbreak happens—whether it’s a coronavirus or something else.”

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10 minutes ago, GreenspointTexas said:

I actually think this is going to be way worse than most are predicting. I think 3/4 of the US is likely to catch it, with 7-15% of those who caught it being severe cases. Thats roughly 15-30 million people who will want to be/have to behospitalized. We only have 100,000 icu beds in the entire country

 

you bout to see the most epic re-purposing/healthcare mash unit this world has ever seen. Every surgery center, every hospital, every place that has an oxygen outlet... occupied. And stays will likely be 2-4 weeks. 
 

this world as we know it now bout to be shut down for a while. 

That's just like, your opinion

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Only comparing mortality rates as a means of comparing influenza to covid19 is missing 3/4 of the information. Add in the communicability difference, the natural and inoculated immunity difference, and the hospitalization rate difference, and you can see why one is more dangerous than the other. At least this season. 

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11 minutes ago, Pato del Muerto said:

Only comparing mortality rates as a means of comparing influenza to covid19 is missing 3/4 of the information. Add in the communicability difference, the natural and inoculated immunity difference, and the hospitalization rate difference, and you can see why one is more dangerous than the other. At least this season. 

Username checks out. 

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