the Coronavirus outbreak thread

[RNHC]

Originally Posted by joeychitwood

I’m baffled by your blindness to the scale of human suffering and the seriousness of the slow motion disaster occurring on our planet.

Is Covid-19 the only thing that is causing large scale human suffering? Is it the only serious slow motion disaster facing our planet? Was everything rosy and peachy in the world before Covid-19?

[77T]

Originally Posted by RNHC

What got me puzzled is the dramatic difference between Italy and Germany's mortality rate - 10.1% and 0.6% respectively. I read various possible explanations from touchy-kissy Italian culture to extensive testing in Germany but I am not sure any of those theories can explain such a vast difference.

I’d suggest the deaths in the stats are probably reliably reported - but the denominators are not reliable. I believe such a wide disparity has nothing to do with social habits or treatment efficacy.


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[statsman]

A couple of days ago, I questioned Russia’s stats. Here is an explanation I could d-

https://www.google.com/amp/s/abcnews...%3fid=69717763

Russia has a COvid-19 test. It is not sensitive, and gives lots of false negatives. And Russia is having a very deadly “pneumonia” season.

[statsman]

Originally Posted by 77T

I’d suggest the deaths in the stats are probably reliably reported - but the denominators are not reliable. I believe such a wide disparity has nothing to do with social habits or treatment efficacy.


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I believe you’re absolutely right. Italy is only testing those with severe symptoms. Germany is testing everyone with a contact, or who goes to a doctor with symptoms.

[RWH]

Originally Posted by statsman

I believe you’re absolutely right. Italy is only testing those with severe symptoms. Germany is testing everyone with a contact, or who goes to a doctor with symptoms.

Yep South Korea aggressively tests anyone with contact as well hence making their cases manageable. China was also able to get it under control by building or establishing quarantine centers for those even no showing symptoms even without testing as long as there is contact.

[Recondope]

Originally Posted by statsman

A couple of days ago, I questioned Russia’s stats. Here is an explanation I could d-

https://www.google.com/amp/s/abcnews...%3fid=69717763

Russia has a COvid-19 test. It is not sensitive, and gives lots of false negatives. And Russia is having a very deadly “pneumonia” season.

I also saw on article (will link if I find again) in regards to Russia considering legislation that would jail people who break the quarantine orders from 3-7 years. Additionally anyone whom is a known positive for Covid-19 that breaks quarantine and subsequently infects another that results in death would be charged with terrorism. It definitely seems that their numbers could be much higher than have been reported.

[jatco]

Originally Posted by RNHC

Is Covid-19 the only thing that is causing large scale human suffering? Is it the only serious slow motion disaster facing our planet? Was everything rosy and peachy in the world before Covid-19?

IMO, No, it wasn't..as we all probably are aware of,, thru info-commercials etal.. asking to support/donate to this and that program.
Taking into consideration all the famine and loss of lives, young and old, in the less fortunate, '3rd' world countries, where they can't even obtain Clean water, meager food supplies, etal. 'They' are Still and always will be, seeking help, just to exist.
And we think we have it bad..? Just sayin'
(hope my comment is acceptable..) !

[Art 1]

Originally Posted by jatco

IMO, No, it wasn't..as we all probably are aware of,, thru info-commercials etal.. asking to support/donate to this and that program.
Taking into consideration all the famine and loss of lives, young and old, in the less fortunate, '3rd' world countries, where they can't even obtain Clean water, meager food supplies, etal. 'They' are Still and always will be, seeking help, just to exist.
And we think we have it bad..? Just sayin'
(hope my comment is acceptable..) !

I agree. And agree with the person you quoted. I imagine quite a few Africans starved to death today, and yesterday and will tomorrow and the next day.

[TheVTCGuy]

Originally Posted by RNHC

With updated numbers as of March 25, 2020 (note the slight uptick in mortality rate):

According to NY Times, for every confirmed coronavirus case, there are five to ten undetected cases out there.

https://www.nytimes.com/2020/03/16/h...ndetected.html

The latest US mortality rate derived from worldometer website is 1.4%.

https://www.worldometers.info/coronavirus/country/us/

If you account for undetected cases, the coronavirus mortality rate drops by a factor of five or ten - giving us actual mortality rate of 0.14% to 0.28%.

Seasonal flu mortality rate was given as 0.1% earlier in this thread.

R0 or basic reproduction number (also called basic reproduction ratio) measures the "contagiousness" of a disease.

Covid-19 has estimated R0 of 2.2.

https://www.ncbi.nlm.nih.gov/books/NBK554776/

Seasonal flu has estimated mean R0 of 1.3.

https://www.ncbi.nlm.nih.gov/pubmed/19545404

CDC estimates that so far this season there have been at least 38 million flu illnesses, 390,000 hospitalizations and 23,000 deaths from flu.

https://www.cdc.gov/flu/weekly/index.htm

According to worldometer website, US has had 928 deaths from coronavirus so far.

https://www.worldometers.info/coronavirus/country/us/

OK, I’m a Dorklehead with a lot of topics, stats are one. This “RO”. Can someone explain, does this information basically state that Corona is not quite twice as deadly as a normal influenza? RO of 1.3 to 2.2. ?

Thanks.

[statsman]

Russia claims 600 cases, but the CDC isn’t buying it. They are raised to Level 3.

[Fleetlord]

Originally Posted by TheVTCGuy

OK, I’m a Dorklehead with a lot of topics, stats are one. This “RO”. Can someone explain, does this information basically state that Corona is not quite twice as deadly as a normal influenza? RO of 1.3 to 2.2. ?

Thanks.

R0 is essentially how contagious it is...

https://www.healthline.com/health/r-...duction-number

[Dawg2]

Originally Posted by statsman

A couple of days ago, I questioned Russia’s stats. Here is an explanation I could d-

https://www.google.com/amp/s/abcnews...%3fid=69717763

Russia has a COvid-19 test. It is not sensitive, and gives lots of false negatives. And Russia is having a very deadly “pneumonia” season.

They are calling it "community acquired pneumonia," not COVID19.

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[TheVTCGuy]

Originally Posted by Fleetlord

R0 is essentially how contagious it is...

https://www.healthline.com/health/r-...duction-number

Grashus

[Cool watch]

The scary thing is that the number of confirmed cases are simply going to spike once we have enough kits to properly test anyone that needs it.

[jatco]

An excerpt and tale ......
.
https://rense.com/general96/healthy-...ot-the-flu.php
.
IMPORTANT
Healthy Nurse's Account Of Surviving
Coronavirus...This is NOT the FLU

From Facebook
3-23-20

ALBANY,GA — 31 year old healthy nurse who has lived thru personally being infected with Coronavirus and hopefully out of the dark. ****** #stayhome
COVID19 is NOT like the flu...at all. How do I know? Because I've lived through it to tell the tale.

Memoirs and timeline of a 31 year old male with no underlying health conditions.

March 3, 2020-Bronchitis like illness started, dry cough, no fever

March 5, 2020-Low grade fever starts, still thinking bronchitis

March 6, 2020-Fever climbs from 99.8 to 102.6 in one hour, thought it was flu and was now outside the Tamiflu window, stayed home for symptom management.

March 9, 2020-Fever of >102 continues, this isn't flu, go to urgent care, diagnosed with pneumonia, started on Levaquin.

March 11, 2020-3 doses of Levaquin in, no improvement in symptoms, go to ER. Admitted, swabbed for COVID19, IV antibiotics got pneumonia on chest CT.

March 12, 2020-Get to a room and placed on supplemental oxygen via nasal cannula, 1 liter per minute (lpm). I'm only able to achieve 500 on my incentive spirometer, for perspective-my healthy lungs could hit 4000.

March 13, 2020-O2 saturation begins to decline, oxygen increased to 2 lpm, then 3 lpm, then 5 lpm. Oxygen saturation 88% on 5 lpm. The decision is made to use high flow (vapotherm) and move to ICU. Placed on 40 lpm and 60% oxygen. I'm terrified at this point because vapotherm is all that is standing between me and the ventilator. This is the moment I would have died at home had I not come to the hospital when I did. I would have respiratory arrested in my bed.

March 14, 2020-I have a bad coughing spell, my oxygen saturation drops to the 80's. I'm still on 40 lpm and 60%. I'm trying to gasp for air but because of the condition of my lungs, can only take small breaths without coughing more. I feel as though I'm about to die, my heart is racing, oxygen still low, and I'm sweating profusely. Im in respiratory distress! I pressed my call light trying to get the attention of anyone who can help. My nurse was in another room tending to another sick patient.

Fortunately, he sees me, and comes to my room. I am now on 40 lpm and 100% oxygen, next step is the ventilator. I'm terrified. My breathing slows as my oxygen saturation slowly returns to the 90's. I'm weaned back down to 60%. The same thing happens again in the night, and again I thought I was about to leave this world. Again I'm on 100%, this time for several hours. I'm slowly weaned again to 60%.

March 15, 2020-My morning arterial blood gas (which hurts like a ) is normal. I get weaned to 50%.

March 16, 2020-My oxygen saturation is 97%, I'm weaned further to 30 lpm and 40%.

March 17, 2020-I've been in ICU 4 days, forced to use a bedpan because my oxygen saturation drops if I turn or even move too much. I am unable to clean myself; I'm feeling completely helpless and so embarrassed, but my nurses were great and very understanding. I now truly understand my patients' feelings from all these years of nursing. I'm weaned to 25 lpm and 30%. I'm going to the medical floor.

March 18, 2020-I'm weaned to 28%. I can achieve 1500 on my incentive spirometer finally. I'm hopeful to be weaned to a regular nasal cannula. The provider comes in. I've been waiting for my swab results. I tested positive for COVID19...6.5 days of waiting for the outside lab to process the lab. I'm relieved because I finally have a diagnosis, a reason I've been so sick. I'm weaned to 4 lpm on a regular nasal cannula, 4 hours later I'm weaned to 2 lpm. 4 hours later I'm weaned to room air. My oxygen saturation stats 93% and above all night.

March 19, 2020-As I write this, I'm waiting to attempt a 6 minute walk test to see if my oxygen stays up, so I can go home. I've had no visitors this entire time due to my isolation precautions.

Guys, this is why social isolation is THE thing. As a 31 year old, I wasn't supposed to get sick. I wasn't supposed to be admitted to the hospital or the ICU for that matter. We've already had several deaths from COVID19 in this area. I thank God I wasn't one of them! However, many won't be as fortunate as I have been.

Many will die, especially those with any lung or heart problems. So please, I beg you to #stayhome

**Working in healthcare it's easy for us to downplay people getting sick. A lot of us wasn't taking this seriously because it seemed so much like the flu but the make up of this virus is different. The RNA mutating is basically uncontrollable and that's what's so scary. It's okay if you weren't taking it seriously because this is uncharted territory and a lot of us was in denial but you need to change that mindset. This isn't going to get better if we don't start staying home. I'm not personally worried about if I get sick but I'm horrified at the thought that I could be the reason someone dies.

Think about that last statement and stay home please".
.
Just wanted to share...fwiw.

[gtnator]

Dummies:


Louisiana pastor defies COVID-19 stay-at-home order, holds services for hundreds

https://www.latimes.com/world-nation...irus?_amp=true


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[Carry The Interest]

Originally Posted by mbalmz

this is long but I found it pretty helpful... this is a covid-19 doc at weill cornell (one of the largest hospitals in NYC).

Thanks for sharing this video. This, along with all the candid intel I've been reading on this thread from members around the world is one of the reasons I continue to come back to this thread.

[BBL]

Does anyone know where all the clinical studies are currently being conducted on chloroquine/hydroxycholoroquine and accompanying medications?

I found a CDC statement, but it didn't address selection sites.

Hopefully, the controlled studies will define efficacy r/t CV19.
In the meantime in my area, several have voiced they would advocate for 'off label' administration as a last resort if they considered they had no other treatment options if they were in crisis.

A friend sent me this interview with Professor Didier Raoult in the Parisien newspaper March 22, 2020, infectious disease scientist in France. Prof Raoult states that he performed a study on Chloroquine and viruses years ago. French and English translation.

I'm providing this link for information, not as a personal endorsement.
https://www.upr.fr/actualite/pour-co...-22-mars-2020/

[JasoninDenver]

Originally Posted by 77T

Lots of numbers to unpack.

This has been a terrible disease for those affected.

The number that I sense is causing major concern for each of us? One.

A loved One.

One of our friends.

One who cares for our health.

One who protects us on the thin blue line.

And for some, Number One.

That’s when it hits home - not the millions of this, the thousands of that.

I have no problem with your data - it just made me pause to think about what is concerning many of us...


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Best post on this whole thread. Thanks Paul!

[gmh1013]

Originally Posted by RNHC

Do you know anyone who got Covid-19?

From the actual Covid-19 disease, for the majority of the population, not really. For the elderly, yes, it is a serious concern.

Short term, our healthcare system being overwhelmed is a greater concern.
Long term, economic repercussion from imposed restrictions may be the greatest concern.

We had had and survived pandemics in the past without drastic measures.

https://www.seattletimes.com/seattle...1957-pandemic/

Yes...a 27 year old girl....and she is in hospital on oxygen not doing well at all.

[gmh1013]

On the local news they pointed out a new crisis in the making with 10's of thousands getting let go from their jobs, live in apt, most in Houston are over 1k for a one bedroom, cant pay the rent and will be evicted .....some can move in with friends but lots have no where to go but the street or try and live in their cars with a very hot summer around the corner.....and with the stay home order from the city.
As one texted me why are you worried about anything you own a house, no car payments....get S.S. and have money for retirement....the only thing i worry about is getting the virus....while some have to worry about the virus, where are they going to live and where their next meal is going to come from. Most on this forum fit in the fortunate side with not having to worry like some of the younger people now. It seems like its getting worse by the day now with this crap.

[Uggi]

I've got a question for Joey and the other doctors on here who are seeing this first hand.

One of the peculiar aspects of this virus is how is affects different people so differently. One of my employees has a wife with chronic Crohns disease and she is so full of steroids that she has virtually no immune system at all: he always says that when she gets a mild cold is lasts a month. We found out last week that him, his wife and his two daughters (one also with Crohns) had tested positive. Naturally we were very worried. I spoke to him yesterday and they have all thankfully fully recovered and he is back at work (working remotely). He said the symptoms were bad while the fever lasted but otherwise like normal flu. Even for his wife. There are many similar stories.

But alongside the stories of vulnerable or elderly people shrugging it off quite easily there are many horror stories (some in this thread) of young, healthy, fit people ending up in ICU, or worse.

My question is.... how common is it that one virus can show such widely ranging symptoms in different patients or is there a scary prospect that the virus is already showing in different forms or different strains? At the start of this crisis there seemed to be an expected pattern - it will be very bad for elderly or immuno compromised people but not bad for younger, healthy people. That pattern seems to be changing. Do we know why?

[Moggo]

My last thoughts on this subject as my fingers get me in trouble

It’s seems to me that certainly some of the media outlets here in the U.K. are actually getting off on this dreadful pandemic. The rubbish and negativity they pedal daily is truly as bad as the virus.

In no way am I belittling the situation, it is utterly horrendous and I’m on my knees because of it but certainly Sky to name one I believe are going beyond facts and pedalling fear for headlines. I guess a headline of ‘X number of people recovered today’ doesn’t get clicks.

I understand they ‘try’ to present facts but they only present the terrible, don’t offer any hope or morale boosting stories which I believe they should be trying to do.

Just my final thoughts really.

Stay safe all


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[swatty]

Originally Posted by Moggo

My last thoughts on this subject as my fingers get me in trouble

It’s seems to me that certainly some of the media outlets here in the U.K. are actually getting off on this dreadful pandemic. The rubbish and negativity they pedal daily is truly as bad as the virus.

In no way am I belittling the situation, it is utterly horrendous and I’m on my knees because of it but certainly Sky to name one I believe are going beyond facts and pedalling fear for headlines. I guess a headline of ‘X number of people recovered today’ doesn’t get clicks.

I understand they ‘try’ to present facts but they only present the terrible, don’t offer any hope or morale boosting stories which I believe they should be trying to do.

Just my final thoughts really.

Stay safe all


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Same here , sensationalist reporting gets more people watching .

[mountainjogger]

Here is an article reporting that some hospital are considering universal Do Not Resuscitate ("DNR") orders for Covid-19 patients.

https://www.washingtonpost.com/healt...ot-resucitate/

This should drive home the seriousness of the disease and the threat heathcare workers are facing.

Stay safe.

[Speedbird-1]

Some Upbeat News.

The UK Government asked for volunteers to help take some of the strain off of
the NHS. They needed a minimum of 250,000, and expected 150,000 to come forward within a week.
So far they have received over 500,000 offers of help, within 24 hours.
---------------

This evening at 20:00 GMT the whole nation is being encouraged to open their
windows and applaud, all those within the NHS and all the other brave souls that are risking their own wellbeing to keep this beautiful country running.
-----------------

[Zakalwe]

Originally Posted by Uggi

I've got a question for Joey and the other doctors on here who are seeing this first hand.

One of the peculiar aspects of this virus is how is affects different people so differently. One of my employees has a wife with chronic Crohns disease and she is so full of steroids that she has virtually no immune system at all: he always says that when she gets a mild cold is lasts a month. We found out last week that him, his wife and his two daughters (one also with Crohns) had tested positive. Naturally we were very worried. I spoke to him yesterday and they have all thankfully fully recovered and he is back at work (working remotely). He said the symptoms were bad while the fever lasted but otherwise like normal flu. Even for his wife. There are many similar stories.

But alongside the stories of vulnerable or elderly people shrugging it off quite easily there are many horror stories (some in this thread) of young, healthy, fit people ending up in ICU, or worse.

My question is.... how common is it that one virus can show such widely ranging symptoms in different patients or is there a scary prospect that the virus is already showing in different forms or different strains? At the start of this crisis there seemed to be an expected pattern - it will be very bad for elderly or immuno compromised people but not bad for younger, healthy people. That pattern seems to be changing. Do we know why?

The answer to this is undoubtedly complex and probably not completely understood for what is a new pathogen. I’m certainly no expert in immunology or virology but it’s likely that the variation in severity (which is also seen with seasonal influenza) relates more to the host response than to the virus itself.

When you get an infection you generally feel ill because of the response mounted by your immune system. Some people’s immune systems over-react to the presence of a pathogen and it causes collateral damage and it’s these people that can become seriously unwell. Why do a minority react this way whilst most don’t? Genetics almost certainly plays a part. Certain environmental factors may be at play e.g. smoking. Advanced age degrades every system in your body, including response to infections.

The observation about more young people being affected is related to the increasing number of cases over time. It was never the case that young people could not become seriously unwell (the first notable death of the entire pandemic was a young, healthy Chinese doctor) but simply that their odds are much, much better than older people. Again to analogise with ‘flu - it’s known as a disease that seriously afflicts older people but it certainly does also kill young people - 674 annually in the U.K. in the 15-44 age group according to this:

https://www.sciencedirect.com/scienc...63445313003733

It’s just that you never hear about them.

[Uggi]

Originally Posted by Zakalwe

The answer to this is undoubtedly complex and probably not completely understood for what is a new pathogen. I’m certainly no expert in immunology or virology but it’s likely that the variation in severity (which is also seen with seasonal influenza) relates more to the host response than to the virus itself.

When you get an infection you generally feel ill because of the response mounted by your immune system. Some people’s immune systems over-react to the presence of a pathogen and it causes collateral damage and it’s these people that can become seriously unwell. Why do a minority react this way whilst most don’t? Genetics almost certainly plays a part. Certain environmental factors may be at play e.g. smoking. Advanced age degrades every system in your body, including response to infections.

The observation about more young people being affected is related to the increasing number of cases over time. It was never the case that young people could not become seriously unwell (the first notable death of the entire pandemic was a young, healthy Chinese doctor) but simply that their odds are much, much better than older people. Again to analogise with ‘flu - it’s known as a disease that seriously afflicts older people but it certainly does also kill young people - 674 annually in the U.K. in the 15-44 age group according to this:

https://www.sciencedirect.com/scienc...63445313003733

It’s just that you never hear about them.

Great info thanks

[77T]

Originally Posted by mountainjogger

Here is an article reporting that some hospital are considering universal Do Not Resuscitate ("DNR") orders for Covid-19 patients.



https://www.washingtonpost.com/healt...ot-resucitate/



This should drive home the seriousness of the disease and the threat heathcare workers are facing.



Stay safe.

Thanks for sharing - not a fun read. But have been at the edge of that decision as a family member many times over the past few years. I can’t imagine how hard this will be for families touched by the eventuality.

That is very sobering - I wonder what has been the corollary in China, So. Korea, and Italy. Hadn’t seen that in print yet about their experience.



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[brandrea]

Originally Posted by Lt Virgil Hilts

Some Upbeat News.

The UK Government asked for volunteers to help take some of the strain off of
the NHS. They needed a minimum of 250,000, and expected 150,000 to come forward within a week.
So far they have received over 500,000 offers of help, within 24 hours.
---------------

This evening at 20:00 GMT the whole nation is being encouraged to open their
windows and applaud, all those within the NHS and all the other brave souls that are risking their own wellbeing to keep this beautiful country running.
-----------------

There are good, caring people out there. Thank you for sharing