Tag: nCoV

COVID-19 7Mar20 How To Do It Right If You Have/Have Been Exposed To COVID-19

COVID-19 13Mar20 The Game Of Loads And Vectors Gets Real For America

COVID-19 15Mar20 It’s The Rate Of Spread Stupid

The Game Of Loads And Vectors is a game of numbers. Sadly, far to many in the media and online are playing a very dangerous game with the numbers. One group uses each new case, each famous person (or even people related to or vaguely related to a famous person) to stoke fear and panic and/or for personal gain. The other group of idiots is using numbers to claim this isn’t a real threat.

As I’ve noted before, it is not the total number of cases or the number of deaths that truly matters right now. The outcome for people with COVID-19 is going to be vastly different from the outcomes in China, Iran, or elsewhere. Here, the most at-risk population is going to be 70+ with underlying health conditions, and/or those who smoke cigarettes heavily now or previously. A good bit of that has to do with the ACE2 binding previously discussed. For most in the U.S., it will likely be much like having a regular flu.

The real threat we face is in controlling the rate of spread. Why did China, Iran, and Italy have the outcomes they have/are having? It spread rapidly, and overwhelmed the health systems. They simply did not have the beds, the ICU beds, or the supplies to handle the huge number of cases that hit.

Right now, according to the American Hospital Association, there are 924,107 staffed hospital beds in all types of hospitals including psychiatric and other specialty hospitals. There are 792,417 staffed beds in community hospitals. Where there are 97,776 staffed ICU beds in the U.S., only 46,825 of them are medical/surgical intensive care.

While many will have very mild symptoms, there is a percentage of patients that require time in the ICU. This paper looks at data from China (and acknowledges that the official data is problematic) to try to estimate how many that will be, and comes to a max of 2.6 – 4.9 per 10,000 adults. This report looks at Italy and reports a rate of 11 percent needing ICU. This report lays out why COVID-19 is worse than the flu, and looks at the impact on the healthcare system — and on the rate of spread and how it could spread exponentially as in Italy and elsewhere.

So, using the 11 percent figure, there being curretly 2,952 cases in the U.S., that means approximately 325 patients will need long-term (days to weeks) of ICU care. With 46,825 staffed beds, we’re good, right? Yes, we are — today. Will that hold true tomorrow or even next week? The magic ball says maybe. Let’s look at the following two graphs.

This is from the Johns Hopkins interactive graphic that I’ve linked to in almost every post. Note the significant rise associated with the spread of COVID-19 in almost every location. Where spread has not been controlled, there is effectively exponential growth. Now, let’s look at the U.S.

This comes from the CDC, and while not interactive it does have a lot more data than I can show. I would urge you to scroll through the number of cases and watch how it jumps.

Again (and again), there was never any chance to prevent it from getting here, as the Chinese government has lied from the start and used it’s considerable power to prevent other nations from responding by stopping travel. There is no doubt that if President Trump had not — despite howls of outrage from China and the leaders of the Democratic party — put in place a travel ban things would be much worse.

All we can do now is slow the rate of spread. We have to do this to:

• Prevent the spread from overwhelming ICU beds, ventilators, and other medical treatment. Keep in mind that right now Italy has ordered hospitals to stop treating the elderly.

• To buy time to overcome bureaucratic and other roadblocks to testing. Effective, efficient, and fast testing is essential to being sure those who have COVID-19 get treatment and are prevented from helping spread the disease.

• To push the spread out into warmer weather, a time when colds and the flu normally drop off.

• To buy time to develop effective vaccines and treatments and get them made here since the Chinese are now threatening to cut off drug exports to the U.S. (even as they try to blame COVID-19 on us).

What is going on now is not an overreaction to “the flu” as many idiots are claiming. It is a needed, indeed almost a desperate, attempt to prevent our healthcare system from being overwhelmed like far too many others. The number to watch in the days ahead is NOT the number of cases (or who has gotten it), and it is not the number of deaths. It is the rate of spread. If the rate of spread drops, and the total number of cases stays low, we will be in very good shape from a healthcare perspective — and that will drive financial and other perspectives.

Right now, we are in good shape. Let’s all be smart and work together to help keep it that way.

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As always:

I want to reiterate that there is no need for panic, but there is a strong need to be alert, be informed, and be prepared.

Other COVID19/COVID-19/2019-nCoV articles:

COVID-19 14Mar20

COVID-19 7Mar20 How To Do It Right If You Have/Have Been Exposed To COVID-19

COVID-19 13Mar20 The Game Of Loads And Vectors Gets Real For America

COVID-19 14Mar20

If you want to see innovative and effective leadership, you need look no further than to Donald Trump and the Task Force on COVID-19. Rather than seize a crisis to increase the size and scope of the stagnant and ineffective government, he instead showcased the best of American Exceptionalism to partner with industry on innovation that is already having dramatic results. I’m not surprised given some of the partnerships and investments in private enterprise solutions to find cures and speed development of vaccines, but yesterday was unprecedented. The declaration of emergency is clearing out the logjam of regulation so that real and effective steps can be taken and a host of problems solved.

Apparently others noticed this as well. The stock market didn’t just stage a rally, it had what is being reported as a record rise after the President announced his declaration and outlined the various steps being taken and had the leaders of the companies involved say a few words. Then, he had real experts on pandemics and related issues talk — as usual. He pointed out, correctly, that this is something that affects us all and requires government, industry, and even private citizens to work together to address. Contrast this with Pelosi et al and the despicable efforts to load the spending bill with pork and efforts to expand the bureaucracy. For me, I’m noting those who would play politics with the lives and safety of our Citizens and the Republic, and urge you to do so as well.

Also, contrast this with a media that has repeatedly lied, deliberately provoked panic, and now is openly promoting Chinese assets spewing propaganda. And the talking heads wonder why public trust in, and viewership/readership, has taken a nose dive.

More to say, but for now it will have to wait. I simply note that if not for the Trump economy, we would be in real and severe financial trouble. If not for the quick response of the President, responses taken despite efforts by political opposition and the deep state, the infection rate would be far larger and the spread far faster. I am more than impressed with his leadership in this crisis, and anyone who can look at the facts should be as well.

•My Amazon Wishlist

As always:

I want to reiterate that there is no need for panic, but there is a strong need to be alert, be informed, and be prepared.

Other COVID19/COVID-19/2019-nCoV articles:

COVID-19 7Mar20 How To Do It Right If You Have/Have Been Exposed To COVID-19

COVID-19 13Mar20 The Game Of Loads And Vectors Gets Real For America

Starting with a bit of humor today, as the vast majority of people in the U.S. have not been paying attention and for them the world turned upside down yesterday. Beloved celebrities, sports, music, movies, and more. For the majority, many of whom who reacted with anger and more, the Game Of Loads And Vectors just got real.

For me, I just wish this one had been real. Fake news, outstanding troll, and really well done. Sadly, it’s not and what follows is all too real and all too frequent

Thanks to Larry Correia and Jessie Barrett for this

There really isn’t a lot to say right now. This never has been (and never could have been because of the Chinese) about prevention. It is about slowing the rate of infection so as not to overwhelm the medical system. It is about slowing the rate of infection to allow time to ramp up resources, do research, and develop both treatments and vaccine(s). It is about protecting as many lives as possible, along with the economic health of the Republic and its Citizens.

Sadly, we are behind the curve. Not because of the Administration or Trump or Pence, etc. No, the failure rests squarely on the shoulders of the elite, the pros, the deep bureaucracy/deep state. Don’t believe me? Well, here’s this in the New York Times and here’s this in Reason. Then, go read this about a different aspect of the failure of the CDC to prepare to perform their basic and fundamental mission.

Why does it matter? Well, immediately it matters because that lack of preparation and failure to do the job not only spreads infections, but results in needless deaths. This comparison of the difference in outcomes between Italy and South Korea puts it in black and white. It also matters in a few months, when we vote not just for candidates, but between freedom or an expanded inflexible incompetent bureaucracy (a la China, Iran, and several other countries). Seriously, use the interactive graphic to compare outcomes between those with robust systems and competition to those that are state monopolies. Interesting difference, no?

As for why those now braying that it is no worse than the flu are wrong, this is just one point but it is a good one. Those saying it’s just the flu are idiots on par with those claiming it doesn’t exist and those claiming we’re all gonna die. Ultimately, there is no real difference between them.

Is it going to get worse? Yes. The infection will spread. Potentially to millions of Citizens. What matters is the rate of spread. The more it is slowed down now, the better the outcomes on every level. The spread is not a failure on anyone’s part. The rate of spread, however, may well be a massive failure on the part of the bureaucracy if it is anything but slow.

Again, there is no need to panic. In some ways, it is worse than the flu, and in others (for others) it is not. What is needed is rational thought, rational preparedness and response, and just general rationality. To get the latter (or most any of the rest) turn off the media. Then, try turning on your brain. Read, study, listen, learn.

But, hey, don’t listen to me. I’ve only been a science writer (former journalist) for more than 30 years covering medical/biomedical research during much of that time; been involved with medical/biomedical research to varying degrees for more than 10 years; and earned my basic Military Emergency Management Systems certification and badge. Obviously, by the standards of the politico/media elite, I have no clue what I’m talking about.

As always:

I want to reiterate that there is no need for panic, but there is a strong need to be alert, be informed, and be prepared.

Other COVID19/COVID-19/2019-nCoV articles:

COVID-19 7Mar20 How To Do It Right If You Have/Have Been Exposed To COVID-19

COVID-19 11Mar20

Want to avoid the suffering of COVID-19? Do these three steps: 1. Shut off the media. 2. Wash your hands and follow other basic flu protocols. 3. Don’t panic.

Pretty much too late for that for most, but turning off the media is a good first step to a rational response to all that is going on. If you think you’ve got COVID-19 or have been exposed:

I’m pleased to see that two of Indiana’s largest universities are implementing e-learning as a means of helping slow/stop the spread. A number of other colleges and universities are doing the same. Now if we could get all schools, colleges, and universities here and across the nation to do it… My recommendations of the last two days still stand. We need to get ahead of things to win The Game Of Loads And Vectors.

I’m also disgusted. I’m disappointed in the panic; disgusted at the reprehensible and frankly dishonest reporting and panic-mongering by the politico-media class; and, at the apathy towards the clear need to reform and refine our capabilities to fight threats like this.

As always:

Use the interactive graphic to keep track of things. Is COVID19 an epidemic? Yes. Is it a Pandemic? Not according to WHO, but most everyone else is saying yes, it is. Is there need for panic? No. Should you be paying attention? Yes. Hell yes. Should you be preparing? Yes, better late than never.

I want to reiterate that there is no need for panic, but there is a strong need to be alert, be informed, and be prepared.

Other COVID19/COVID-19/2019-nCoV articles:

COVID-19 7Mar20 How To Do It Right If You Have/Have Been Exposed To COVID-19

COVID-19 9Mar20 The Game Of Loads And Vectors

Going to have to be short and sweet this morning, as other duties call. Trust me, would rather be here doing this and other writing than doing what I have to do this morning.

An elementary school student is now the third confirmed case of COVID-19 here in Indiana. The school district where the student lives has wisely (IMO) chosen to implement a system-wide e-learning day today (diagnosis was yesterday) and has announced that the school the student attended will be closed for two weeks. Students there will take part in e-learning and other learning opportunities during that time.

Frankly, I think it would be a good idea for this to go statewide as soon as possible. Right now, we have few confirmed cases and a somewhat reasonable number of what I would call probably exposed. These are people who had more than casual contact with one of the people infected, but not constant contact.

Epidemiology is, in many respects, a game of loads and vectors. You need a certain number of microbes of any type to infect any one person — the load. That number varies based on health, hygiene, and other factors. You need a means of transmitting those microbes, such as sneezing, touch, etc. — the vector.

Washing your hands and strong personal hygiene reduces the number of microbes on you at any time, especially those that could travel via the hands to the mouth, nose, and eyes. Staying ten feet away from anyone sick is a good way of avoiding transmission via cough, sneeze, or just breathing. Being careful what you touch, using the disinfectant wipes at the store on the handles of the grocery cart, and all those other things reduces the amount of microbes that can get to you. You’ve cut the load.

Now we get to vectors. We are still in the early days of this, but we also have an opportunity to break one or more vector chains. If we close all schools, colleges, and universities; and, if along with that we urge people to stay home, cancel public events, and encourage private events to postpone, there is the chance to break vectors relating to physical and airborne transmission. Break enough of the vector chains, and the spread will slow or even stop (temporarily).

This buys time for treatments to be developed, vaccines developed and produced, and will prevent overloading the medical system. It’s a prudent move, though I doubt it will happen. If it doesn’t happen this week or next, the odds are it will be done several weeks too late to be truly effective.

As always:

I want to reiterate that there is no need for panic, but there is a strong need to be alert, be informed, and be prepared.

Other COVID19/COVID-19/2019-nCoV articles:

COVID-19 7Mar20 How To Do It Right If You Have/Have Been Exposed To COVID-19

COVID-19 8Mar20

The panic is off and running. Want to avoid getting it? Wash your hands, often and well. Consider sterilizing the things you use often as well, such as your keyboard, cell phone, tooth brush, etc. A single molecule/virus is unlikely to infect you: the key is to reduce the load of any microbe below that load needed for infection.

This virus has not acted normally, and now we have a better understanding of why. A friend kindly provided me with links to three studies that have shed new light on how COVID-19 infects people, and it is both fascinating and interesting. Fascinating from a biomolecular viewpoint and interesting in terms of some of the questions this news raises.

This paper outlines how the virus shares an ACE2 receptor with SARS. ACE2 expression explains some of the oddity of who it infects and why it has been more deadly in China. Short version is that ACE2 expression is small (to non-existent) in healthy lungs; but, as we grow older it starts to crop up. When you live with heavy air pollution (such as China) and if you are a heavy cigarette smoker, your lungs are damaged, increasing the expression. This paper gets into the smoking aspect.

The real kicker, however, is that COVID-19 has a mutated gene similar to Ebola and SARS that gives it up to 1,000 times the ability of SARS to bind with human cells. There is a lot of detail to be found in this article at the South China Morning Post.

The good news out of all of the above is that ACE2 inhibitors and a number of HIV drugs may work on COVID-19, or at least slow it down. It opens up several fronts on fighting the disease while effective and efficient vaccines are developed. How and why it developed the similar mutation to Ebola and HIV is a very interesting question. Another question is how much damage the virus does to the lungs, and if it is permanent as this article suggests.

Meantime, the fight is on continuing to throttle the rate of infection spread here in the U.S. So far, that strategy is working despite the CDC (hat tip to Insty) and others. The testing issue is major, as is CDC staffers hanging up on doctors who disagree with them and incidents like this that are far more frequent than is being reported (again, hat tip to Insty). The goal is to slow it down so that warmer weather will slow it further. Why?

As I noted in a previous post, unchecked it will overload the system, just as it has done in China and elsewhere. This report from Business Insider notes that hospitals have been warned to prepare for 4.8 million hospitalizations in a worst-case scenario. By the way, if you are looking for reasonably good and accurate coverage, keep the BI coronavirus search going, and also stay up with the South China Morning Post coronavirus coverage. Also, Instapundit runs frequent updates and collections of stories that are a good resource.

Failure to do things properly is partly the blame with what has happened in Washington State and elsewhere. Improper responses have caused dozens of first responders and health care professionals to have to be quarantined, taking them out of the fight for the time being. I say yet again, if you are a first responder or medical professional, go to the highest level of protocol that your agency will allow. You won’t do anyone any good in quarantine.

Slowing the spread prevents overloading the system. If you suspect you have COVID-19 or have been exposed, do like the person in Indianapolis discussed yesterday: call your state health department and work with them so that you can be dealt with in a way that minimizes the chance of spreading the virus to those helping you and to the general public.

Here in Indiana, IU Health has launched a free online screening process. I expect to see more efforts like this, as it will allow people to be screened efficiently and effectively while limiting exposure and spread.

The continued kicker is that based on anecdotal evidence, there seem to be a higher number of “superspreaders” who also appear to be spreading while asymptomatic. The latest (again from BI) is in NYC and there are 20 cases linked to him.

Again (and again), the best defense is to wash your hands frequently and well, and to use hand sanitizer when you can’t wash or between washings. Want to do more? Avoid unnecessary travel and avoid large gatherings (esp. since many cases have come from conferences and such, including CPAC). Work form home, telecommute, and use virtual meetings for as much as possible. Do not shake hands. If someone is visibly sick and/or not following good protocols (hand washing, covering mouth and nose when sneezing/coughing, etc.) avoid them by about ten feet if possible. If you are 70 plus and/or have health issues, stay home as much as possible. If you have to go out, follow the above stringently. Been at a crowded event? Wash, bathe, and wash your clothes. You don’t need to kill every germ, just enough to stay below the load level.

Again (and again), COVID-19 is NOT Capt. Tripps. So, stop the panic and freakout. It is worse than the flu to certain populations, surprisingly mild in some ways outside of those populations, and right now the mortality numbers here in the U.S. are well below that of flu, which kills between 12,000-61,000 people in the U.S. each year. And, note that thanks to the early travel restrictions, the U.S. has the lowest per capita infection rate of any country with more than 100 cases by a significant margin. So, again, please stop the panic. You can safely ignore most of the media coverage, especially if it focuses on the political angle. So far, such reporting (and the politics) have almost 180 degrees from reality.

Your response to this, ultimately, is as important — if not more important — than the government response. You have the power to protect yourself. You have the power to avoid spreading it. You have the ability to think, plan, and prepare if a general quarantine is put in place for your area.

Think.

Yes, it’s hard and the media is stoking the panic for all it’s worth. All the more reason to stop, think, learn, and do what is right for you and for your fellow citizens.

So, wash those hands, cover your nose and mouth when sneezing or coughing, and don’t go running into an area crowded with already compromised people if you think you have it (i.e. a doc-in-the-box, ER, etc.). Think, then act. Use an online screening process, call your state health department, or similar step and then do what they tell you to do.

Final quick note: bureaucracies are not fast and responsive, particularly when they have mission bloat. That said, for all that some elements of the CDC (and WHO and others) are fucking up by the numbers, there are good people in all them who are having to fight their own administrations (not The Administration) to try to get things done. My hat is off to them, and if there is any way I can help them I’m glad to do it. I have a fond but faint hope that one good to come out of this is that some long-overdue reforms of the CDC and FDA may finally happen. It’s time to have the experts in charge again, not political administrators. Both need to be lean, mean, and flexible — something they are far from being now.

As always:

I want to reiterate that there is no need for panic, but there is a strong need to be alert, be informed, and be prepared.

Other COVID19/COVID-19/2019-nCoV articles:

COVID-19 7Mar20 How To Do It Right If You Have/Have Been Exposed To COVID-19

Heh

Just read where a scientist is claiming that those who regularly drink hard liquor may be/are immune to COVID-19. That pretty much means that most troops and veterans I know are safe. It may also mean that Vodkapundit is immortal. I would just remind him that “There can be only one!”

COVID-19 7Mar20 How To Do It Right If You Think You Have/Have Been Exposed To COVID-19

We now have our first confirmed case of COVID-19 here in Indiana. It is a case study in how to do things right if you think you have, or have been exposed to, COVID-19.

The basic story is here. Whatever I may think of the person for having gone to an event at this time, they did things right in a way that should become the text book example of what to do if you have/have been exposed to COVID-19.

Note that they contacted the state health department as soon as they suspected. Working with them, they went to a hospital and parked away from everyone else. They contacted the hospital by phone, who had already been contacted by the state. This allowed them to have those responding take all appropriate precautions. They then took the person in via an entrance not normally used by the public, after putting them in clothing/gear to prevent spread. They was taken to an area of negative pressure for testing. Given that the case is mild at this time, they was taken out the same way and put in quarantine at home.

All of this allowed for: protection of the medical team/first responders involved; it allowed easy decontamination of the areas where this person went; it ensured that the chance of spread to anyone — especially other patients — was minimized.

Note that they did not go to a doc-in-the-box; they did not go to the ER directly; and, they minimized exposure to the public. This is how you do it.

Doing my normal bi-weekly shopping yesterday, I saw panic. People were wearing masks, which is in many respects idiotic. The one person I saw doing it right was from our SE Asian population and they were wearing a mask because they clearly were ill. I steered well clear of them. The others, well, not so much and not so well. Good luck finding disinfectants, hand sanitizer, etc. If you waited until now to begin preparing, well, sucks to be you. Failure to prepare is preparing to fail.

Again, wearing a mask if you are sick is a good idea. If not, you are mostly asking to be sick as few know how to put them on, how to wear them, and — most importantly — how to take them off without increasing your risk of infection. Masks, gloves, and other precautions require you to treat them as hazmat, not just throw them in the trash.

Again (and again) the best way to protect yourself here in the U.S. is to stay away from anyone obviously ill, and to wash your hands well and frequently, particularly after using the bathroom. In between washings, use hand sanitizer on a regular basis. Keep your booger hooks away from your face as much as possible. Don’t shake hands. For me, I like the idea of using the Vulcan salute instead.

Given that most people, especially those falling for politico-media fear mongering, have less sense than God gave a cherrystone clam, I would avoid crowds and as much as possible and avoid medical triage areas such as doc-in-the-boxes and ERs. Most people are not, unless educated by posts such as this one and actual medical statements, are going to flock to such places en masse which will increase the rate of exposure and the rate of infection.

If you think you have been exposed, or that you have COVID-19, do like this person. Call your state or local health agency and work with them so as to minimize the chance of exposing anyone, especially medical or other first responders.

Per my previous posts, if you are a first responder of any type, go to the highest level of precaution your department will allow — especially if responding to a report of someone ill. We can’t afford to have a dozen or more first responders quarantined for each incident as happened in Washington state (see previous posts).

With luck, planning, and people taking sensible precautions, the spread of COVID-19 can continue to be slowed until the weather gets better. There is a reason winter is worse for the flu, and the longer we can put off major spread the better. Also, keep in mind that the majority of cases are going to be mild, in keeping with a flu epidemic (which we have every year). There are a number of reasons it will not be as nasty and deadly here as in China (again, see previous posts). Panic will not help, and in fact will hurt. If you are older (60+) and have underlying health conditions, go to full, stringent, flu precautions as you are the most likely to have real problems with COVID-19. Right now, based on data from here in the U.S., 70+ with underlying health conditions is where we have the highest mortality.

It will be at least another 4- to 6-weeks before we have good data on COVID-19 here in the U.S. Data from China, Iran, etc., is both highly suspect (hint, the Chinese government and other governments have and are lying) and not directly applicable. Don’t panic.

Best thing you can do, other than washing your hands frequently, is to prepare for a possible quarantine. Make sure you have food, medicines, and other supplies to stay at home without leaving for at lest two weeks. This includes financial preparations where possible. Stock up prudently, in that what you buy should be what you normally would eat, drink, need. That way, if not needed, you simply fold it into your normal operations and move on while saving some money on food and such on the far end.

This is NOT Capt. Tripps, and while it will be a pain in the end, it is not something over which to panic. Unless you are in that specific demographic for it to be bad or fatal, you will get by. The major impact will be economic, though I suspect/hope it will change how we do business on several levels. We’ve slowly been trending towards remote work, and I expect that to become more the norm. I won’t object if handshaking becomes a thing of the past. For those smart and fast, there are some potentially fantastic business opportunities as we rightly move away from single-point failures in the supply chain.

Again, and again, and again: it is not a cause for panic. Be smart, be informed, and take media/politico reports with a tun of salt. Instead of a tun, maybe even a ton or two of salt.

As always:

I want to reiterate that there is no need for panic, but there is a strong need to be alert, be informed, and be prepared.

Other COVID19/COVID-19/2019-nCoV articles:

COVID-19 6Mar20

Short and sweet this morning, as am having to go in to work waaaay early. Way to early IMO, but…

Stop with the panic. There is no need to panic here in the U.S. Yes, there are cases and it is here. Are we ‘wereallgoingtodiebecauseorangemanbad’ as the media and far too many politicians are saying? NO. Is our economy going to tank because of this? No. In fact, if anything, we have quite the opportunity to come out stronger and better. It will get interesting, and some sectors are going to be hit harder than others (travel/tourism for example). But, again, thanks to the economy and incentives, and with some judicious additional incentives, we could see a boom that could put all past booms to shame.

As always:

I want to reiterate that there is no need for panic, but there is a strong need to be alert, be informed, and be prepared.

Other COVID19/COVID-19/2019-nCoV articles:

COVID-19 5Mar20

COVID-19 4Mar20

COVID-19 3Mar20