This is what having the novel coronavirus looks like pic.twitter.com/mu7Sj1pq28
— Tech Insider (@techinsider) March 22, 2020
Not sure we've communicated well enough that social distancing interventions will pay dividends in 1-3 weeks. Anything that happens in the next 10 days was already baked in prior to that. A surge in cases now would NOT mean that social distancing isn't working.
— Kate Allen (@katecallen) March 20, 2020
The coronavirus did not escape from a lab. Here's how we know. https://t.co/hDfoJDIp6n
— Peter Daszak (@PeterDaszak) March 21, 2020
Beijing absolutely orchestrated a cover-up and triggered this global pandemic. And the White House has been insanely, dangerously, unforgivably incompetent. Both narratives are true and have unfortunately existed in deadly unison. Binary thinking will help no one. https://t.co/6COj7rjTik
— Alex Gladstein (@gladstein) March 21, 2020
Gov. Andrew Cuomo says new cases of #coronavirus up by 3,254 in #NewYork since yesterday. There are now 10,356 confirmed statewide. Majority are in NYC: 6,211.
Says state is carrying out more tests per capita than #China or #SouthKorea and more tests means more confirmed cases.— Melissa Kent (@KentUNCBC) March 21, 2020
For every confirmed case of coronavirus, another 5 to 10 are out there undetected, a new study indicates. These cases are often milder and, on average, about half as infectious as confirmed ones — but are responsible for nearly 80 percent of new cases. https://t.co/DFjEyUHZpg
— NYT Science (@NYTScience) March 22, 2020
Physicians at the epicenter of Italy’s #Covid19 outbreak warned that medical practice may need to be turned on its head — with care delivered to many #coronavirus patients at home. https://t.co/3zVIptN5c6
— STAT (@statnews) March 21, 2020
In these times of crazed panic-buying, here's Angela Merkel showing how it's done:
– one (1) pack of toilet roll
– a smattering of sundry items
– four (4) bottles of wineThis is the correct procedure. https://t.co/TMAkshKAlk
— Jeremy Cliffe (@JeremyCliffe) March 21, 2020
South Korea may be a model for slowing disease’s spread. The woman behind the plan is showing the world how to fight an epidemic https://t.co/Pks8bYWJml
— Bloomberg (@business) March 22, 2020
Guangdong government texts my mainland mobile number 2 weeks before the annual tomb sweeping day – Qingming – to ask people to postpone the tradition of visiting graves of ancestors in order to avoid mass gatherings.
“Your health is the best consolation to the deceased.” pic.twitter.com/fbL8n3nEdy
— Kinling Lo ??? (@kinlinglo) March 20, 2020
#China state media report a Chinese vaccine is being tested on humans. Volunteers from the epicenter Wuhan between ages of 18-60 have received the injection. (#China has indicated it wants to win the global race for a #coronavirus vaccine.) https://t.co/XDrRv3l4wa
— Eunice Yoon (@onlyyoontv) March 21, 2020
The number of imported #COVID19 cases in China has increased from 85 to 269 over the past 10 days, with an increase of 216%, which is faster than the 98% growth rate of confirmed cases globally during the period, according to the National Health Commission on Saturday. pic.twitter.com/Wi3qjM9IHL
— People's Daily, China (@PDChina) March 21, 2020
Average social contacts in Wuhan declined from 15 per day to 2 after COVID-19 control measures went in. Reproduction number (R) is proportional to contact rate, so this change in social behaviour let to a dramatic reduction in R, comfortably below the R=1 threshold for control https://t.co/xQ4Mnnpr5k
— Adam Kucharski (@AdamJKucharski) March 21, 2020
#JUSTIN HK gov will prosecute three people who returned from mainland China and broke the home quarantine order. They will be mentioned in court next week.
Four more were found violating the order and sent to closed quarantine centre today. They will also be prosecuted. pic.twitter.com/EooLHaafI3
— Xinqi Su 蘇昕琪 (@XinqiSu) March 21, 2020
Indian Railways cancels all passenger trains till March 31, due to #Coronavirus. pic.twitter.com/sKY70sU8v1
— ANI (@ANI) March 22, 2020
'It's a powder keg': South-east Asian countries grapple with virus https://t.co/F6UnqJqbdT via @brisbanetimes
— ɪᴀɴ ᴍ ᴍᴀᴄᴋᴀʏ, ᴘʜᴅ ????? (@MackayIM) March 22, 2020
Australia now has more than 1000 confirmed cases of coronavirus .. case numbers rising steeply over last 2 days. ABC is compiling the latest statistics from states and territories .. This graph is up to 7.30 tonight https://t.co/Zz8B3oVSHM pic.twitter.com/Wb7fss0Ivi
— Joe O'Brien (@JoeABCNews) March 21, 2020
Prime Minister Jacinda Ardern has just announced a four level alert system for COVID-19 and has asked all people to stop non-essential travel. These guidelines are set out below: pic.twitter.com/VU7MYHDSJQ
— Kiri Allan (@KiriAllan) March 20, 2020
BOGOTA, March 20 (Reuters) – Colombia will enter a nationwide quarantine from Tuesday night, President Ivan Duque said late on Friday, the most drastic measure implemented so far by the South American country as it seeks to prevent the spread of the fast-moving coronavirus.
— Vincent Lee (@Rover829) March 21, 2020
As the number of people with novel coronavirus in Canada grows, Indigenous doctors are warning community members to temporarily halt ceremonies like sweat lodges that could spread the virus and put elders at risk.https://t.co/TcHwlFHgq4
— Angela Sterritt (@AngelaSterritt) March 21, 2020
“I knew it was going to be bad, but we deal with the flu every year so I was thinking: Well, it’s probably not that much worse than the flu. But seeing patients with COVID-19 completely changed my perspective, and it’s a lot more frightening.” https://t.co/djMbTz6Wyt
— Dr Kathleen Bachynski (@bachyns) March 21, 2020
.@ScottGottliebMD has been a smart commentator on #covid19 and fwiw I agree with everything in this thread. Read it to get an idea for where we are heading. And once again part of it will be: testing, testing and more testing https://t.co/5eBUgUODmp
— Kai Kupferschmidt (@kakape) March 21, 2020
maybe it because people like you encouraged them to be produced in china https://t.co/qVF8536LlT
— Nice social Democrat ↙️↙️↙️? (@opinion_left) March 21, 2020
Just got a call. An unfortunate milestone in Washington, D.C.:
The area's Medical Reserve Corps is activating. It's asking health care professionals like me to volunteer to conduct COVID-19s testing.
This creepy automated message puts it out: pic.twitter.com/k3zGauZIvX
— Tim Mak (@timkmak) March 21, 2020
1. I hate to invest precious time on taking apart the atrocious @aginnt article pictured below, but it is getting too much traction here and even in traditional media.
This thread could be far longer than it is, but I'm doing my best to only discuss the most glaring flaws. pic.twitter.com/EFA7ATQRbX
— Carl T. Bergstrom (@CT_Bergstrom) March 22, 2020
Also note: Dr. Iwasaki @VirusesImmunity pointed out that humidifiers may be a good intervention for preventing coronaviruses from lingering in the environment in your home. In my house, we've kept our humidifiers going thanks to her lab's great work!https://t.co/ByGly9OwxU
— Dr. Angela Rasmussen (@angie_rasmussen) March 20, 2020
This is a REALLY helpful thread. Please don't wear gloves if they aren't required for your job.
If you wear gloves anyway, follow these instructions to safely remove and discard them. https://t.co/imVERqRcGd
— Dr. Angela Rasmussen (@angie_rasmussen) March 21, 2020
Not all surfaces are created equal: Coronavirus can survive for several days in some cases, according to a new study published in The New England Journal of Medicine pic.twitter.com/uExLOn0kuW
— QuickTake by Bloomberg (@QuickTake) March 22, 2020
La Nonna
This morning’s call and text around for our circle of 30 or so living nearby, 2 people sick with dry cough, intermittent fever, body aches and pains. The calls are in to their family doctor, we’ll see what happens later today. One a heavy lifelong smoker, the other in the high risk age group. Conte announced an even more thorough lockdown for Italy, details to come out today. We are now prepared for this to last til Autumn, at least. The house, garden, and pets have never been so well groomed as now! Common courtesy now in Puglia seems to be wear the mask even if you are asymptomatic, lots of local seamstresses making their own, as we did. Police are doing random checks near the roundabouts at the entrances for the main rojtes into the small villages and cities here, I think now we will be limited to only 1 person per auto, and that self-certification updated for every trip.
opiejeanne
This was in my mailbox today, from the Seattle Times. This is the hell that Italy has been living for several weeks, and it may become ours shortly:
State preparing to make life-or-death decisions if coronavirus overwhelms health care system
Washington state and hospital officials have been meeting to consider what once was almost unthinkable — how to decide who lives and dies if, as feared, the coronavirus pandemic overwhelms the state’s health care system. The triage plan would assess factors such as age, health and likelihood of survival in determining who will get access to full care and who will merely be provided comfort care, with the expectation that they will die.
La Nonna
@opiejeanne: Indeed, we are resigned and aware that should we need aggressive treatment, we will be triaged out to palliative care due to age, and in Il Nonno’s case, many underlying comorbidities. We have had 10 years of beautiful retirement in one of Italy’s garden spots, unspoiled by mass tourism, with the bonuses of great universal healthcare, low cost of living, warm and open society, la dolce vita indeed. Mille grazie ad Italia, no matter what happens. The hardest part has been to explain this to our grown children in the US, it will be a quick cremation, no funeral, no travel doe any of this.
R-Jud
@La Nonna: I hope the end of this year sees you both enjoying Italy again. Stay safe.
Geminid
I hit Kroger’s for more groceries yesterday. The shelf stockers were still going hard, and brown rice was still absent. Most shoppers were briskly going about their business, but I noticed one woman I guess in her fifties who was just trudging along, with a five year old child sprawled in the cart with the groceries. He looked tired, but the woman I assume was his grandmother looked exhausted. I thought later that if I were king of the world my economic stimulus plan would start with giving grandmothers raising children $1000 a week. Trickle up economics.
gene108
Couldn’t sleep well. Felt flushed, when I went to bed. Woke up at 3:30 after very intense dreams. Can’t fall back asleep.
Checked temperature at 5 am and it was 102. Checked 20 minutes ago, it was 99.1. Didn’t take any medication
Just very strange. No body ache, fatigue, etc.
Contacted doctor’s office. See what they recommend
satby
@La Nonna: I echo R-Jud’s hope that you and Il-Nonno come through this epidemic and get to enjoy not just your life in Italy, but a reunion with your family in the future.
@gene108: and here’s hoping your temp is a false alarm!
WereBear
@La Nonna: I will be wearing a mask here in NY. The governor’s speech said “if near vulnerable persons” and since I don’t know, masks will reassure others.
I hope you can weather this and be part of Italy’s recovery.
WereBear
So the idiot in chief is going to sell this bio-weapon conspiracy theory to his minions? Even though it is completely made up by his giant ego?
Cutting off his media access, at least by “reputable” sources, seems even more prudent now.
OzarkHillbilly
Somebody directed me to this site: The COVID Tracking Project
Pretty basic data, but reliable in that they grade the reliability of the data. For instance, the Michigan data gets a D, Minnesota’s an A, Mississippi’s a B, and Misery’s a C.
Their system for grading:
Anyway, looks good to me.
New Deal democrat
If the diagnoses grow in the next 10 days at the same rate as they have in the past 10 days, 10 days from now the US will have over 500,000 *diagnosed* cases.
Since voluntary “social distancing” started in earnest about 10 days ago, we should have a good handle on whether it is significantly effective or not. I predict it will fail, and there will be absolutely enormous pressure for more States to order total lockdowns.
Baud
@gene108:
I was like that two nights ago. It’s an allergy related sinus infection for me. I get them all the time.
YY_Sima Qian
I just returned from hospital stay at Wuhan, after going to the ER for internal stomach bleeding a couple of weeks ago. I am now resting and recuperating, in self-quarantine at another place of ours for a week, before heading home. It was an interesting experience at the designated non-COVID hospital (one of the top ones in the city):
ER: I got to the ER after mid-night, and it was quite crowded. Patients overflowed into the corridors and reception area. The first thing nurses did was to check temperature. Anyone higher than 37.3 C had to go to the fever clinic, instead. Then a quick consult with the ER doctor, who prescribed a full blood panel and upper abdominal CT scan, and I had to wait at the ER for a bed to become available in the hospital ward. A full COVID-19 screening was required for before any in-patient stay: nasal PCR swab + blood test for SAR-CoV-2 antibodies + chest CT scan for early signs of pneumonia, all came back negative for me. All tests results were available within one and half hours. I was placed in a wheel chair for five hours, while on IV (including a blood coagulant shot to stop the bleeding), before an wheeled gurney became available for me to lie down on. It was another five hours before I was told I could transfer to a buffer ward. Two weeks ago Wuhan was still adding over 100 confirmed cases a day, so I was hyper alert at the ER. Fortunately, I did not hear anyone with dry coughs, and no one seemed to have shown positive on COVID-19 screening (I think there would have been arguments between the families of patients and the medical staff if that happened). All patients and family members wore masks. None of the patients at the ER were in good shape. Many people in this city had been putting off visiting hospitals during the epidemic, allowing moderate illness to progress to severe. Some have been waiting at the ER for days, or going from hospital to hospital, waiting for a bed to open up. The ER felt understaffed, as many from the hospital are still stationed at the designated COVID-19 hospitals, or are under 14 day quarantine after a COVID-19 hospital is closed after the discharge/transfer of the last patient. All ER medical staff wore full protective gear, as if they were working in a COVID-19 ward: surgical mask over N95 mask, eye goggle, face shield. full body protective suit, double gloves, double shoe covers.
Buffer ward: Standard protocol is only non-COVID patients need to stay in a buffer ward for three days, for observation whether he/she develops COVID-19 symptoms, before transfer to standard ward. Only those that pass the COVID-19 screening at the ER can even get into the buffer ward. On the second day, another nasal PCR swab and blood test for antibodies are taken. Any caretaker for the patient has to go through the same screening process. If the caretake had to leave for whatever reason, he/she had to go through the same screening process again before re-entering. Imagine my nerves when I learned that the wife of may roommate at the buffer ward had a weak positive result on the nasal swab! She tested negative for the antibodies and chest CT. Analyzing the situation with him, and consulting my wife’s relatives working in Wuhan’s hospitals and the municipal CDC, I advised him to ask his wife to test again the next day. Thankfully, the next round screening came back negative. It was probably a false positive the first time, due to a bad lab assay. We were kept in a large room that normally hold six patients, but now only two (at the opposite ends of the room to maximize distancing). The buffer wards were divided into the same departments as standard wards (digestive tract illness in my case), and staffed with the relevant doctors and nurses from the respective departments. The idea is to get started with treatment during the observation period. All medical staff wore the same full protective gear as those at the ER. All patients and caretakers wore masks at all times, we wore masks to sleep.
Standard ward: With the second round of COVID-19 screening coming back negative again for me, I was moved to the standard ward when bed opened up. It was actually more crowded at the standard ward than the buffer ward. The four person room I was staying was fully occupied, with three patients and a caretaker for one of the other patients. Everyone still hd to wear masks, even while sleeping. Nurses still wore full protective gear. Doctors were somewhat less rigorous (some did not bother with goggles and/or face shield), perhaps because they interacted less with patients. While there were beds in the hallways, the hospital did not accept patients to be placed there, perhaps due to understaffing.
Treatment: Due to fear of COVID-19 infection, Wuhan’s hospitals have placed on hold all invasive procedures, except in life threatening circumstances. Therefore, the doctors treating me could not order a gastroscopy exam to assess the bleeding wound. Therefore, the doctors could only assess me via my vital signs, external symptoms, and test results from blood/stool samples. They ordered a blood transfusion, since my hemoglobin count was low, and I was looking quite pale. I was on IVs for a full week, before liquid food for another week. 8 – 10 bags of IV per day, from antibiotics, to medicine to rebuild and protect the stomach lining, to vitamins/electrolytes/nutrients. I also got upper and lower abdominal CT scans to confirm there is no tumors. In normal times, when the doctors could assess the bleeding would with gastroscopy and order blood transfusion early, I probably would have been discharged in a little over a week. My company also has an international emergency medical assistance service on retainer for its expats, and I had doctors from Beijing and Shanghai calling me every couple of days to check on my status and review the course of treatments. They concurred with treatment plan that the doctors at the hospital developed. After the lock down ends in Wuhan, I will have to come back for gastroscope to assess the nature and the status of the wound in the stomach.
Cost: All COVID-19 related screenings (two nasal PCR swabs, two blood antibody tests, one chest CT scan) were free. For the two weeks of in-patient stay, two CT scans, a blood transfusion, 10+ blood tests, stool sample test, 8 – 10 bags of IV per day, total cost was under 20K yuans, or less than 3K USD, without medical insurance. My international insurance will probably cover 85% of that.
All in all, not a bad experience. The medical treatment was professional, though bedside manners a bit uneven (most medical staff were fairly friendly). The hospital has all the modern equipment one would expect at such an institution. The facility was aged, and the furnishing mediocre to begin with and not that well maintained (discoloring no the walls and ceiling at some places). The odd cockroach crawling out of the sewer was not pleasant. The hospital’s newer campuses in other parts of the city are much more modern, and much better furnished.
As I was discharged, Wuhan had zero new confirmed cases for two consecutive days (four days now). There is rumbling that the lock down measures will start to be eased from early Apr., if there is fourteen consecutive days of no new confirmed cases. Companies deemed important to national and international supply chains are busy applying for permits to reopen in the next week. Some key enterprises actually resumed work from Feb. 10 (Huawei’s R&D center, Lenovo’s plant, large LCD plants, semiconductor fabs, optical fiber plants, plants making lasers, companies making medical supplies and equipment and medicines). I was very lucky not to have developed internally bleeding earlier. There were no designated non-COVID hospitals in late Jan. to early Feb., only segregated ERs and wards, but the risk of nosocomial infection there would still have been very high, assuming a bed was available. Even after designated non-COVID hospitals opened in early to mid-Feb., some of their ERs were seeing 30 – 40% of their patient also infected with COVID-19. Too many non-COVID patient (and their family members) had been desperately going hospital to hospital for days in search of available beds, and had unknowingly infected. Hence, the protocol I described above.
The above protocols also explains why China is claiming greatly reduced nosocomial transmission since early Feb., and that none of the 42K medical personnel sent from rest of China to reinforce Wuhan have been infected. With the rapid fall in active cases in Wuhan, those doctors and nurses from the rest of the country are not returning home, to heroes’ send offs and welcomes.
JPL
@YY_Sima Qian: Continue healing.
Baud
@YY_Sima Qian:
Thank you for your reporting. Feel better.
NotMax
Android phone? Be alert about malware that’s been showing up.
WereBear
@YY_Sima Qian: Glad to hear from you!
Steeplejack (phone)
Sam Wang suggests tracking deaths is more useful than tracking “cases.”
satby
@YY_Sima Qian: I am sure I wasn’t the only one a bit worried by your absence from commenting! Glad you’re home and better.
YY_Sima Qian
@Steeplejack (phone): Deaths can lag infection by 3 – 5 weeks (10 weeks in outlier cases), depending on the quality and availability of care. The feedback loop is far too long to be of utility for public health policymaking. For academic study, perhaps.
debbie
@gene108:
It’s not unusual to have a higher temperature when you first wake up, especially if you sleep under covers. More so if it’s a down quilt.
New Deal democrat
@Steeplejack (phone):
I read that.
Here’s the problem: how do we know that the people died *as a result of the coronavirus*? Most likely, *because they were tested*!
So I don’t think Wang’s reasoning quite holds up. Also, diagnoses tell us that the disease has infected *at least as many people* who test positive. So it is useful that way.
I think the best measure is the ratio of tests to diagnoses. South Korea’s pandemic peaked when that ratio rose to 15:1 for five days. I think yesterday the US ratio was about 8:1. Not good.
debbie
@OzarkHillbilly:
Huh. DeWine has been very proactive here in Ohio, yet we rate a D.??♀️
YY_Sima Qian
@satby: Thanks for the concern! Digestive tract illness are often associated with stress, so I have been taking it easy. Ironically, in the month and half of lock down my diet has been by far the healthiest in a long long time (little alcohol, no carbonated drinks, no cold drinks, no greasy and salty take outs, much more vegetables). I did not feel any stress from work or personal life. Perhaps the daily onslaught of COVID-19 news, and the strict lock down, had been placing subconscious pressure. Or my digestive system could not adjust to the sudden change of diet…
debbie
@YY_Sima Qian:
Scary, but glad you’re recovering.
WereBear
@YY_Sima Qian: I discovered I was “sensitive” to both fiber and gluten when I dropped them as part of an elimination diet.
People still unaware that this is a real thing can be surprised how their body reacts when they eat like everyone else. That turns out to be a luxury my body can’t deal with.
Just in case it helps :)
prostratedragon
@YY_Sima Qian:
Thanks for the sobering report, and glad you’re out and feeling better.
For comparison, I had the same problem during Christmas (when else, I ask you), with the complication of being on warfarin, which made it a bit dramatic for a day or so. I got a standard bed within a few hours, with several transfusions and some iv fluids that started in the er and continued for a couple of days, after which I was stable enough for endoscopic diagnosis and repair. Between this, and not having to wait out a monitoring phase in the beginning, I was able to get out in about 1 week, though recovery at home continued for several more weeks.
So one can see the strain on hospital systems from having to take many more precautions even with non-COVID19 cases, in addition to the number of serious or critical cases we might have. By the way, even in the golden days of December 2019 I was considered only borderline for an icu bed with a hemoglobin level below 6 and my normal continuous need for O2.
rikyrah
We need phucking massive testing on South Korea’s level ????
comrade scotts agenda of rage
This map is a fantastic display (maybe fantastic isn’t the correct adjective to use) on the spread:
https://usafacts.org/visualizations/coronavirus-covid-19-spread-map/
rikyrah
PsiFighter37
@La Nonna: Yikes. I had booked a trip to South Tyrol (the Dolomites) in early August…in your opinion, you think that is likely to not happen at this rate?
comrade scotts agenda of rage
Want to know how your area hospital bed availability plays out?
https://projects.propublica.org/graphics/covid-hospitals
Xenos
Isolation does seem to be effective where used consistently.
Here in our neighborhood in the EU we were sent home from most workplaces about 10 days ago, and the daily rate of increased infections just today dropped from 50% to 20%. If we can keep this rate under 20%, or even reduce it further for a few days we may turn a corner on this by the time another month passes.
Anne Laurie
@YY_Sima Qian: Thanks so much for all this information — and we’re all very glad that you’re well enough to share again!
YY_Sima Qian
@New Deal democrat: COVID-19 death counts were underestimated at Wuhan and Hubei until mid-Feb., due to lack of testing kits and lab capacity (same thing happening in norther Italy right now). That finally changed with the shift in criteria for confirmation, to including clinical diagnosis. Definition changed back a week later, as test kit availability and lab capacity were no longer bottlenecks. Every place constrained by testing should implement confirmation by clinical diagnosis. There will be higher false positives and false negatives with clinical diagnosis, but it is much better than waiting for PCR test capacity.
Every place should learn how China is managing 200 CT scans per machine per day at the peak of the epidemic. It only takes a couple slices of the lung to make a clinical diagnosis, no need for full scans. Purchase portable CT scanners from China ASAP, instead of relying on the big hulking machines for this purpose.
Lastly, what really pushed actual transmission rate (Rt) down in Wuhan was centralized quarantine of mild cases/suspect cases/closed contacts. There is a Harvard study that estimated Rt in Wuhan during the first three weeks of Jan., without NPI measures, to be 3.8(!!!). The lock down and social distancing measures (closing all non-essential business and manufacturing operations, stopping public transport/taxi/ride sharing/private vehicles, etc.) from Jan. 23 knocked Rt down to 1.2 – 1.3. Better, but that just means a somewhat more slowly but still exponentially growing epidemic. From early to mid Feb., with centralized quarantine of mild cases in makeshift medical facilities, suspect cases and close contacts in hotels and university dormitories, and other further distancing measures (lock downs the community level, with food deliveries arranged, no more grocery shopping trips), Rt was knocked all the way down to 0.3! One does not need to take all of these measures (community level lock down and de facto house arrest might be hard to stomach in the West), but reducing Rt to 0.5 – 0.7 will allow the epidemic to burn out and provide relief to the medical system.
The “lock downs” in Europe and NY and CA likely will not flatten the curve enough to avoid overwhelming the medical systems. These “lock downs” are not as strict as those implemented in Wuhan in late Jan./early Feb., and not paired with massive testing and contact tracing. In fact, they have given up on contact tracing and testing of mild cases. I do not believe these measures will suppress Rt to close to 1, let alone below 1.
I really don’t why the US and Europe are not building makeshift medical facilities at a massive scale to house the clinically diagnosed mild cases. These cases only need a bed, no ventilators, no ICUs, no ECMOs. There are plenty of idle convention centers, indoor stadiums, gyms and mothballed hospitals available. The draw back of self-quarantine at home is continued transmission in the household (75 – 80% of transmission in Wuhan after the lock down). Self-quarantine without medical supervision also increases risk of mild symptoms developing into severe or critical before medical intervention (and this is not limited to the elderly cohort). Centralized quarantine and medical care avoid all of that…
Dorothy A. Winsor
@opiejeanne:
I saw you posted that on FB. Stay safe, opiejeane!
ETA: Biden has a new ad using Trump’s quotes to show how he failed to act. It’s very good.
Mousebumples
@rikyrah: Talked with my sister (MD in a large city, by Wisconsin standards) yesterday, and she shared that her city’s university lab is able to treat ~1000/day. About 4 hours per test, but the backlog of pending tests means its currently about a week to get results. There’s also a shortage of the reagents needed to do the test. That helped to fill in something that wasn’t making sense to me about why some tests were taking longer than others to get results. Hopefully more medical center labs will step up testing capabilities – and innovate better ways to test. (eg is a pregnancy test style at home test feasible? Maybe with spit versus the pee stick style?)
YY_Sima Qian
@prostratedragon: And this is Wuhan well on the down slope of the epidemic, and the medical system here had largely recovered, after massive reinforcement from across the country. Imagine what it would have been like in late Jan., on the steep up slope, before most of the reinforcements have arrived…
YY_Sima Qian
@prostratedragon: Do you mind sharing what was the cost before medical insurance (order of magnitude) for your stay? I have never had to go to the hospital while in the US, so I have no frame of reference. My dad suffered a bleeding ulcer twenty years ago. He had to go to the ER, stayed in the hospital for nearly a week, and was out a few thousand dollars even with medical insurance.
It seems Chinese medical care (aside from surgeries) really is pretty cheap.
Marigold
@debbie: Ohio gets a D because they are only reporting the positive cases, but not how many tests they’ve done in all. 5 positive tests is okay, but there’s a big difference between 5 positive out of 10 vs 5/100 or 5/1000. DeWine has been proactive enough on this that I don’t think they’re trying to hide information, so maybe it’s a problem communicating with the private labs.
New Deal democrat
@YY_Sima Qian: I absolutely agree that most US States are only engaged in half-measures. I agree that we need a Wuhan-style lockdown for at least 2 weeks to get back out in front of the pandemic.
As the cases continue to increase, probably still exponentially, the pressure for such a lockdown is going to become immense. Businesspeople are going to realize that a complete closure for a few weeks is better than an ongoing huge drop-off in business for months.
YY_Sima Qian
@WereBear: Good to know!
Fair Economist
@La Nonna: One of my personal concerns is that if my mother (80’s and severe COPD) catches this it won’t be safe for me to travel to see her when she is ill or to attend the funeral. She is aware of the risks and taking such steps as she can but when you have to have a continual stream of caretakers there is only so much you can do.
Fair Economist
@WereBear: I got a sports mask (reusable) back when this first got reported. It’s supposed to be N99 but the mask’s scheme, which is to use a neoprene covering to hold a filter against your face, allows leaks. Still, it’s a lot better than nothing.
joel hanes
For every confirmed case of coronavirus, another 5 to 10 are out there undetected
This is much, much better than I expected.
In fact, I don’t believe it.
Based on long experience with the statistics of sampling and selection (I once did quality testing for semiconductors that went into enormous mainframe computers) I’d have been willing to bet that the actual number is somewhere between a hundred and a thousand.
Fair Economist
@New Deal democrat: Mild to moderate social distancing makes a huge difference. Here’s a comparison of Tennessee to Kentucky:
https://twitter.com/RickSmithShow/status/1241461583848640517
Probably not enough by itself but it will buy time to get people to stricter measures, or to fire up testing, which should expand a lot next week with a rapid test being approved.
joel hanes
@Fair Economist:
I’m in the same boat.
PsiFighter37
@Fair Economist: I think it is inevitable that sad situations like this will happen. I missed catching my flight out to CA to see my grandmother, because someone at my work got the virus and I didn’t want to chance it. My mom, who is effectively stuck out there, can only go and see her because she feeds her lunch and dinner – otherwise cannot go and see her. She is in far worse shape than she was just 3 months ago…very groggy and barely awake, dementia much worse (IMO – barely cognizant of surroundings), and she just got diagnosed for hospice care. If, as it seems inevitable, that the nursing care facility has to completely lock out everyone else, then it’s possible the my grandmother will pass with no immediate family present. That would suck – but I think it is inevitable.
debbie
@Marigold:
Ah, thanks.
Fair Economist
@YY_Sima Qian:
We are not yet at the point that anybody with a fever can be presumed to have COVID, so people would not be willing to go to such facilities. We would need to be able to test everybody symptomatic, and we are far from that.
Fair Economist
@joel hanes: @PsiFighter37:
Best wishes to all our endangered relatives.
debbie
This’ll kill Trump. What are the odds he’ll say he never wanted to kill Obamacare?
YY_Sima Qian
@Fair Economist: That is why I am saying clinical diagnosis. At least in Wuhan, clinical diagnosis means a combination of fever, dry cough, and early signs of ground glass pattern in the lungs from chest CTs. If you tell people that they are developing pneumonia with high likely hood being caused by SARS-CoV-2, they might be willing to get away from their families and get to a place where they can receive some medical care, and can arrange ambulances to go to the hospital if their situation deteriorate.
South Korea did much more than massive testing and contact tracing, that is just information gathering. The actual response is case isolation. Every confirmed case is sent to hospital or medical quarantine. None of this self-quarantine of self-diagnosed mild cases at home, and poorly enforced at that.
L85NJGT
Heroic medicine is largely a fiction of entertainment. A hospital has a hard capacity determined by staffing and facilities. Once that has been reached, jamming patients into converted ORs isn’t medicine, it is just really shitty hospice care, with the added benefit of staff and outpatients becoming infected and sharing to the broader community.
The salient point from YY_Sima Qian is what to do with those diagnosed with moderate symptoms. House calls\home monitoring? Dedicated temporary facilities? Something else?
Lyrebird
Yeah I looked, thanks to NYT making COVID 19 articles free, and this is the rest:
So the proportion is likely to be different in NYS or in NV or in Florida, and in all cases worse.
I am one of the newly online instructors for a college that sent its students home. No testing on the students first. We do not know if we just protected our students or if we just put their home communities at greater risk.
aaaaaaaaaaaaaaah…
MazeDancer
The New England Journal of Medicine has issued the definitive word on how long COVID-19 infectious parts can live and infect people on various surfaces:
Plastic: 72 hours
Stainless Steel: 48 hours
Cardboard: 48 hours
Copper: 8 hours
Let those deliveries sit outside.
joel hanes
@Lyrebird:
China had much more testing available than currently exists anywhere in the United States, so that makes perfect sense.
debbie
@MazeDancer:
Thank you for sharing this information. It’s really very helpful.
kindness
It would be proper karma for China to start blaming the United States for importing the virus to them. Trump would blow a fuse. Twofer.
different-church-lady
No, you haven’t. All anyone has been communicating is SEAL YOUR MOUTH WITH DUCT TAPE AND WAX AND DON’T LEAVE THE HOUSE FOR 18 MONTHS!!1!
Sister Rail Gun of Warm Humanitarianism
@MazeDancer: Link? Because that’s not the numbers I’m seeing in this report.
WereBear
@Fair Economist: Fortunately I am married to an airbrush artist. We each have a particulate mask to use if we go out to a public place.
And plenty of trailheads nearby.
germy
Marmot
Skip that poorly written LiveScience article and go straight to the Nature journal article.
https://www.nature.com/articles/s41591-020-0820-9
Suzanne
@different-church-lady: I think I agree with you here.
In order to actually get Americans to do this, our leadership should be giving us clear guidance about what to expect, and it needs to be workable. The president is worthless. And we need to know how well this is working and by when.
germy
debbie
@Suzanne:
Every single death from COVID-19 is on Trump. Period.
germy
Future Republican president vows revenge:
debbie
@germy:
Spoken in safety from behind his mother’s skirts. //
germy
@MazeDancer:
That information is from a letter published in the NEJM on March 17, 2020, and includes this disclaimer:
trollhattan
I wonder if Jacinda Ardern is reconsidering her career path? She’s had one rough ride as PM and somehow managed to give birth in the midst of it, further complicating things a bit.
trollhattan
@germy:
A reckoning? What sort, tariffs on viruses?
Miss Bianca
@Dorothy A. Winsor: btw, Station Eleven? Great book, but dear God, why did I think that *now* would be a good time to pick up a sci-fi dystopia about a plucky little traveling theater company wandering about Michigan, my old home state, after a plague wiping out 99% of humanity?
It’s like getting field reports on what my life would be after the End of the World As We know It.
That said, I will keep reading. : )
PenAndKey
@germy: These fuckers are already planning their next war, and they’re too stupid to realize they’re threatening the one country on Earth that the US relies on so much that a trade embargo against us would cripple us.
Yes, they really are that stupid. They tried the same saber rattling shit before 9/11 when the Hainan Island incident occurred.
catclub
and i feel fine.
Terry Chay
@New Deal democrat: you act like failure is binary. It isn’t.
You act like nobody will see any difference in real world results between where and when different areas implemented different measures. They will.
Already the difference between Seattle and New Orleans stands in stark contrast to San Francisco and Santa Clara.
ziggy
@YY_Sima Qian: So good to hear from you again! Very interesting to hear your take on the responses so far in the US. I’m going to have to chew on that dedicated hospital idea. I think if things continue to deteriorate, US citizens might actually cooperate. I’ve been surprised at how compliant (for the most part!) people have been, at least around here.
Also VERY encouraging to hear how the situation in Wuhan is finally resolving. Hope life returns to a more normal state for all of you soon.
ziggy
I think it would be very helpful if people started wearing masks in public. Obviously there isn’t enough manufactured ones at present, hopefully that situation can improve soon. But what about making your own at home? Or wearing a scarf wrapped around the lower face? Especially in situations such as grocery stores, it would help protect other people from asymptomatic virus carriers. Is anyone seeing that in the general public, other than asian stores?
Terry Chay
@Steeplejack (phone): Sam is wrong.
– Deaths lag by three weeks
– Deaths early on are a tiny sample size, too small and too slow to mean anything.
– Deaths are a big function of: patient age (Seattle), awareness of COVID-19 (Wuhan, Seattle, Northern Italy), and whether the medical system locally fails (Italy, Wuhan).
This last one by itself gives a 5-10x difference in mortality rates.
The reality is testing is the better indicator but be aware that it is affected by the number of people tested and the time it takes to get the results.
terry chay
@PenAndKey: These people won’t be in office to rattle the sabres.
I don’t think people really comprehend the political impact of this disease. I don’t think I can really comprehend it. All I can say with certainty is that the uncertainty is astronomical because the risk is not measurable.
It is uncharted territory. But people such as Cotton are doomed.
Steeplejack (phone)
@Sister Rail Gun of Warm Humanitarianism:
Warning, please, on PDF files. Some devices, particularly phones, don’t show the whole link and/or download the file automatically.