Covid 19 virus

[not1xor1]

If you are infected you should wear a mask, if possible, to protect others close to you

NO
if you are infected you must quarantine yourself, stay at home or go to the hospital if you can't breath

the main problems are:
1) lots of people do not realize they are infected since are symptom-less
2) a few sociopath know they got the disease (some even tested positive) and just behave carelessly

AFAIK they caught one who knew he was positive but went shopping to the supermarket and another asshole who knew he was sick, but didn't want to miss his planned nose plastic surgery and so didn't tell the medical staff and infected some of them

[not1xor1]

SARS and COVID-19 are also transmitted via feces...
I've non idea why, but AFAIK nobody observed pet-to-human transmission

From what I've read covid-19 is *not* transmitted by feces.
Do you have a credible study that states differently?

there are registered cases regarding the SARS virus (via a defective bathroom aeration system in a Hong Kong building)
while COVID-19 has been detected in feces and tears besides that diarrhea is one of the known symptom (together with loss of taste and smell senses)

[Cerebus]

If you are infected you should wear a mask, if possible, to protect others close to you

NO
if you are infected you must quarantine yourself, stay at home or go to the hospital if you can't breath

the main problems are:
1) lots of people do not realize they are infected since are symptom-less
2) a few sociopath know they got the disease (some even tested positive) and just behave carelessly

AFAIK they caught one who knew he was positive but went shopping to the supermarket and another asshole who knew he was sick, but didn't want to miss his planned nose plastic surgery and so didn't tell the medical staff and infected some of them

I hate people who quote me out of context. What was the last thing I wrote in the same very same post you're quoting just part of?

Lastly, if you are infected, or have good reason to believe that you might be infected - stay at home, do not go out in public unless strictly necessary. The question of "mask or no mask" doesn't come into it if you've put a door and some distance between you and the rest of the world.

[flyte]

Well people, Belgium has just increased measures one step before a total lock-down:

- Everyone stays at home unless for essentials or really needed to get to the workplace
- One person per 10m2 in supermarkets
- Maximum groups of 2 persons allowed in public
- Social distancing mandatory including for all companies and public transport
- If not followed, police will fine and/or close down facilities

Something tells me by the end of next week this will be considered too soft and a total lock-down will be the case.

Some infected people who had less luck here have now posted reports or videos from their hospital beds, begging our fellow citizens to take this extremely seriously because, being healthy in their 40's and 50's they did not expect it to be that bad. They said it feels like hell, is painful and with extreme exhaustion. No visits, total isolation and doctors come and go dressed like martians. Whoever still doubts this is no more than just another flu, is a lost case, I'm afraid.

[Cerebus]

while COVID-19 has been detected in feces and tears besides that diarrhea is one of the known symptom (together with loss of taste and smell senses)

[Citation Required]

[hamster_nz]

In case you haven't stumbled upon it yet, https://www.worldometers.info/coronavirus/#countries seems to be a good place for stats.

[not1xor1]

Italy was hit hard because they didn't quarantine the first two cases that they found back in early February.  Around the 2nd they had two Chinese tourists that were sick and were hospitalized but they allowed them to continue of their tour of the country and to go on a cruise. Weeks later when Italians started getting sick, the authorities started finally started some very limited quarantines but by then hundreds of people all over Italy were infected as well as numerous people in the surrounding countries and some had traveled back the US and to Canada.  About one week later, the number of cases in Italy exploded. Then about a week after that, the number of cases in many of the surrounding countries also exploded.

That's a huge pile of bullshit.
Are you just the usual fascist looking for any chance to spread your bloody fake news?
Shame on you.

Anybody who can read Italian might check what REALLY happened from respectable Italian newspapers like Corriere della Sera or Repubblica or Sole 24 ore (I'm unsure, but they might publish in English too)

The first two cases in Italy where two Chinese tourists in Rome. They were very civil and sensible people who quarantined themselves wearing masks, staying in the hotel room and restricting from touching other people.
Once they felt worse, they called the emergency number. The procedure for that kind of emergency was ready, so they sanitized the room and checked all the people who had got in touch with the tourists. Nobody else had been infected.

The tourists were immediately put into isolation and fully recovered after a few weeks in ICU (A study showing the rapid and severe damage to their respiratory system is going to be published soon).

Italy was the first country (and afaik the only one) in Europe to block direct flight from China, one of the first to get back and quarantine Italian nationals from there and constantly monitored people who had suspicious symptoms for possible contact with infected zones.

The problem is we did not have a patient zero here in Italy, but various patient ONE. None of them had got in touch with anybody else coming from China and positive (no antibody) to COVID-19.
So when those people went to the hospital with respiratory problems nobody at first thought it was COVID-19. Most of them were more than eighty and/or with other severe pathologies so the doctors thought they were dying of ordinary flue.

Then there was a young and fit Italian guy who started to show strange and strong respiratory symptoms. He was the first one to be tested for COVID-19. He had a friend who had come from China a couple of weeks before. But his friend was clean. No symptom, no antibody of a past infection.

Once that first patient was discovered they started to test medical staff and later recent deaths and so discovered the virus had been spreading in several hospitals unnoticed for a couple of weeks.

Patient zero might have been a German national (as for a recently published German study) who got infected during mid January and then transmitted the disease to colleagues who have been in North Italy a short while later. But that's no longer relevant as the disease had already spread widely and since sick people do go to hospitals where there were several infected medical staff the disease spread very quickly and wildly.

It was just the worst combination of unlucky and unlikely events, a perfect storm.

[DrG]

Just released yesterday - report 16 March 2020 Imperial College COVID-19 Response Team

This is the UK "study" that you have, or will be reading about with mortality rates that will be making headlines.

https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf

   Wow!  The onset of infectiousness is 12 hours to 4.6 days! That should set off alarm bells!

I am still going through it....Yes, there are a lot of alarm bells there. Not just the summary disease effects statements. The projections based on modelling the effects of various NPIs are more than sobering. For a while now, I have been hoping that there were feasible strategies (in the US)  that could support the Health Care system without it being overwhelmed to the point of dysfunction, were possible. Now, I am, sadly, rethinking that.

Please, someone tell me that I am not reading this correctly....e.g., A1...

Figure  A1: Suppression  strategy  scenarios  for  US  showing  ICU  bed  requirements.  The  black  line  shows  the unmitigated epidemic. Green shows a suppression strategy incorporating closure of schools and universities, case isolation and population-wide social distancing beginning in late March 2020. The orange line shows a containment   strategy   incorporating   case   isolation,   household   quarantine   and population-wide social distancing. The red line is the estimated surge ICU bed capacity in US.  The blue shading shows the 5-month period in which these interventions are assumed to remain in place. (B) shows the same data as in panel (A) but zoomed in on the lower levels of the graph.



See that vertical horizontal red line - that is the surge critical care capability [US]. See how, that line is crossed under ALL of the NPI scenarios?!  That is what I want somebody to tell me that I have read wrong. Please. If I am reading it correctly AND they are right with their analysis, we have a VERY limited window to develop effective PI, period, beginning, middle and end of headline.

[rgarito]

Wouldnt surprise me.  In fact, I'd be concerned about what they call "surge capacity."

In the hospitals I worked in, even on a Friday/Saturday night, the ERs were always so packed that "surge capacity" meant parking beds at pre-marked locations in the hallways.

And yeah, you are reading that correctly....  These are not exactly "isolation wards."

ICU's are generally pretty heavily used.  And I'm concerned about the EQUIPMENT.  Hospitals only have a limited number of ventilators.  VERY limited.  And a very limited number of people qualified to run them.

[Cerebus]

You mean horizontal line. But, no, you haven't read it wrong. Critical Care facilities are not sized to cope with this. In the UK Critical Care beds (at 8 per 100,000 population) get overflowed in anything other than a mild flu season. I doubt the US is in any better situation despite having 14 critical care beds per 100,000.

[not1xor1]

[...] influenza and coronaviruses are among the things we should be prepared for.  [...]

There really should be portable equipment/resources at the EU level that can be flown in to hot spot areas to help quell outbreaks,  without each member country having to shoulder the cost of maintaining a high level of preparedness.   A perfect job for a shared institution like the EU.

Has an emergency response plan even ever existed in EU? Does not seem to be so.

Even if such a plan existed it doesn't help because the EU as a whole is so densily populated that a problem quickly spreads across all countries.

the real problem is that there is European but no real Union.
Recently an Italian importer managed to order a huge amount of breathing devices from China. Then when they arrived in Hamburg the German government seized them for their own usage.
Surely we can't go on like that.

[Martin72]

Then when they arrived in Hamburg the German government seized them for their own usage.

Evidence please...

[not1xor1]

I hate people who quote me out of context. What was the last thing I wrote in the same very same post you're quoting just part of?

Lastly, if you are infected, or have good reason to believe that you might be infected - stay at home, do not go out in public unless strictly necessary. The question of "mask or no mask" doesn't come into it if you've put a door and some distance between you and the rest of the world.

I apologize, you're right
I had missed that

[not1xor1]

while COVID-19 has been detected in feces and tears besides that diarrhea is one of the known symptom (together with loss of taste and smell senses)

[Citation Required]

can't provide that as it is from an Italian newspaper reporting about a German study... I just read that a few hours ago
probably other sources will publish that piece of news soon

[Cerebus]

Wouldnt surprise me.  In fact, I'd be concerned about what they call "surge capacity."

Surge capacity typically means diverting critical care beds that would normally be reserved for planned operations that need CCU support (e.g. transplants, other major surgery with potential post-op complications) and (in the UK) putting CCU beds into use that have been mothballed due to lack of resources (e.g. staff) to keep them in regular use. CCU is very expensive to actively run, with a staff requirement of at least 1 per bed, 24 hours a day, thus it's not unusual for CCU resources to get mothballed if budgets get tight. On the other hand it means that these specialised beds are often sitting waiting for nothing more than a clean, stock check and staffing to be pressed into use - you don't have to wait to acquire equipment de novo.

CCU beds are always in a perilous state as soon as anything goes wrong. My local hospital has 3-4 CCU beds and only expects to have 2-3 in use at any one time, that's only 33% spare capacity in a hospital with 340 regular beds.

[thinkfat]

the real problem is that there is European but no real Union.
Recently an Italian importer managed to order a huge amount of breathing devices from China. Then when they arrived in Hamburg the German government seized them for their own usage.
Surely we can't go on like that.

Uh, wow. Any source for that?  The only reference I found with Google was a report of China sending 10000 respirators and experts to Italy. The source for that, however, ... hm: https://www.suedtirolnews.it/italien/china-schickt-beatmungsmaschinen-und-experten-nach-italien

Not what I call reliable.

[tinhead]

i think it was good idea to buy 500pcs "already pre-used" masks from China, they worked for them, so they already rad-hard and will work for me.

[not1xor1]

Then when they arrived in Hamburg the German government seized them for their own usage.

Evidence please...

that was published on several Italian newspaper.
But I know that on March the 4th the German Ministry of Economy and Energy forbid the export of any kind of Individual Protection Devices included the ones I had ordered on mid February from Conrad Electronics.

Afaik France did the same.
OK please check if you can translate this: (it looks like they have been unseized now)
https://www.tgcom24.mediaset.it/mondo/coronavirus-19-mln-di-mascherine-per-litalia-bloccate-da-altri-paesi_16184369-202002a.shtml and can find any reference there.
I'm interested as you to check if that is true.

[Cerebus]

i think it was good idea to buy 500pcs "already pre-used" masks from China, they worked for them, so they already rad-hard and will work for me.

Yeah, good idea. [Fx: turns to audience] "Think of it as evolution in action."

[flyte]

See that vertical horizontal red line - that is the surge critical care capability [US]. See how, that line is crossed under ALL of the NPI scenarios?!  That is what I want somebody to tell me that I have read wrong. Please. If I am reading it correctly AND they are right with their analysis, we have a VERY limited window to develop effective PI, period, beginning, middle and end of headline.

No, you didn't read it wrong. I think the US has few time left to act in a drastic manner, if the aim is to prevent what is happening to other countries who have acted as-needed. Aside from the medical cases and complications, the problem with this virus is:

• high infection rate and highly contagious
• long incubation period of up to 14 days

Unless a country is willing to take very drastic isolation measures before they appear to be needed, as perceived by the general population, the filling up of its medical infrastructure will be caught in speed by the virus, and you're heading straight for the wall. It's not policy or politics, it's math.

If you would able to really take a snapshot of the exact real number of people infected right now, then it's maybe x100 times the current reported number. It's just that these people currently present no symptoms at all and happily infect others. But they will in two weeks. And in two weeks, the actual number of infected individuals will again be a multiple higher than what is being measured then. This goes on until about 60-70% of everyone has been infected, and then it goes down.

And yes, I'm certainly no expert in the matter, but from what I read it seems the US is heading for the opposite, i.e. underestimating it and taking too few measures.

[Kjelt]

Germany as many other eu countries have indeed put an export hold on critical items such as masks and gloves. But what is the story ?
The italians did not allow chinese plains to land so they had to go through Germany? Or why did they not import themselves directly? So yes it looks like that part is true but they are released? Much quicker than any consumer item is released by german vustoms

BTW: our health professionals are now recycling masks since they have an extreme shortage.
I have heard some have to work without adequate protection, doing the best they can. This is insane, insane times. Take care everyone gor yourself and loved ones.

[flyte]

CCU beds are always in a perilous state as soon as anything goes wrong. My local hospital has 3-4 CCU beds and only expects to have 2-3 in use at any one time, that's only 33% spare capacity in a hospital with 340 regular beds.

Well, you could think of this epidemic as a natural disaster occurring everywhere at the same time in a country. That's the main problem with it. This virus has a giant medical care depletion capacity. It's both fast spreading and stealthy for a long time.

[not1xor1]

BTW: our health professionals are now recycling masks since they have an extreme shortage.
I have heard some have to work without adequate protection, doing the best they can. This is insane, insane times. Take care everyone gor yourself and loved ones.

it is the same all over the world and everywhere industries are repurposed to produce respiratory devices and masks
the truth is that everybody should have expected that but nobody did

[DrG]

You mean horizontal line. But, no, you haven't read it wrong. Critical Care facilities are not sized to cope with this. In the UK Critical Care beds (at 8 per 100,000 population) get overflowed in anything other than a mild flu season. I doubt the US is in any better situation despite having 14 critical care beds per 100,000.

Yes, I meant vertical horizontal lin and made that correction twice. I'm not asking for an explanation of hospital bed number or surge capability. That information is available from many other sources and has been for a very long time. Nor is it particularly helpful to simply state "not sized to cope with this", because, in my opinion, it simply sounds too smug. It is the details of the *this* that are up for reasonable discussion, otherwise a simple - "we're fuxored" is sufficient and need not be embellished upon.

What is under intensive scrutiny here is the accuracy of the calculations. Take a step back. What the Brits have done here is characterized the disease with particular respect to required care by the Health Institutions. Further, the course of that load requirement has been projected under different non-pharmacological interventions (NPI).

The most stringent NPI, which we in the US are heading for or are currently at, does not overload health care until a resurgence of infections in NOV. Under that scenario, a window of time exists to develop AND deploy pharmacological interventions, which would mitigate the resurgence in infections predicted for NOV.

To develop and deploy a vaccine in 8 months is unreasonable under any Phase 1, Phase 2a...etc FDA process that I am familiar with. While ~a year gets bandied about, it is a best case scenario in my view. Vaccines, however, are under development worldwide, even though in the US the very first trial has just now begun (afaik).

That, potentially, leaves us with non-vaccine pharmacological intervention in that short time window.

Administering antibodies is not a fantasy (take that #BoomerRemover, we are going to harvest your blood )

Antivirals (all the *virs and others (e.g., https://www.clinicaltrialsarena.com/analysis/coronavirus-mers-cov-drugs/ ) are under consideration. Compassionate use might allow some deployment of some drugs within that time window, but completely novel treatments are going to be subject to the same basic FDA route - again in my view.

So, the prediction of the NOV surge, as described, is a very big issue. If you (i.e., anybody) has read the report, knows a good deal about modelling, and can comment on the confidence of that prediction, I would sure like to hear about it.

[Cerebus]

CCU beds are always in a perilous state as soon as anything goes wrong. My local hospital has 3-4 CCU beds and only expects to have 2-3 in use at any one time, that's only 33% spare capacity in a hospital with 340 regular beds.

Well, you could think of this epidemic as a natural disaster occurring everywhere at the same time in a country. That's the main problem with it. This virus has a giant medical care depletion capacity. It's both fast spreading and stealthy for a long time.

Based on the Imperial College estimates, across all age groups taken together, about 1 in 5 patients that needs hospitalizing because of Covid-19 will need a CCU bed. So a hospital designed to treat Covid-19 would have 1 CCU bed for every 4 regular ones rather that the 1:99 that's something like the normal ratio.