Thursday, March 12, 2020

My, my, myyyy CORONA! ("When you gonna get to me...?")

Joseph here. I've had a couple of questions about the coronavirus. First: I'm wondering how to spell the word: Capital C? Should it be two words? The most common spelling seems to be one word, small c. So I'm going with that, even though it looks wrong to my eyes.

Second: I'm wondering if I caught the thing.

Even though I don't get sick very often, I recently recovered from a bout of the flu. Well...maybe it was the flu. Let's just say that, whatever it was, it's an illness that, on the severity scale, situated itself somewhere between the flu and a cold. For a couple of days, I mostly stayed in bed with a fever.

Unfortunately, I did not have my all-time favorite symptom -- trippy fever dreams. Y'know what I'm talking about? Those intense, hallucinatory, sometimes scary, sometimes groovy, let's-return-to-the-60s dreams? Dreams so vivid that you kinda enjoy getting sick?

None of those. Bummer.

After that came the cough. There has even been some minor difficulty breathing, which never has never been a problem for me before. The sniffles never really showed up; usually, when I get a cold, an annoying degree of congestion lingers for a while.

(AFIB also returned, but that's a cardio issue, presumably unrelated.)

Here's the thing: It was all very low-level. I've had way worse tussles with influenza in the past, and so have you. If that was coronavirus, then what's the big deal? And if it wasn't, then what's the difference between this Big Bad Virus Scaring Everyone and a normal old flu?

Some of you may now be desperate to tell me that I should go to the doctor to find out if my flu was just the flu. Sorry; no can pay. Besides, I'm over it, mostly.

Some of you may now be desperate to inform me that I should quarantine myself. At this point, I must go into crazy-eyed Manson mode: "Man, I been in quarantine ALL MY LIFE! That's where your society has put me, man -- in QUARANTINE! ISOLATED! That's why I'm FREE!"

(Seriously, I have no friends and I don't go places. So, no worries.)

Let's zoom out for the larger question: Just how problematic is this damned virus that threatens to upend our economy? We don't really know how many people have the illness here in the United States, because the tests are not available and the numbers are iffy. We keep hearing the words "two percent fatality."

But is that number accurate? Fauci once said that, when all the facts come in, the real number will be closer to one percent.

In South Korea, where testing is better, the reported death rate is 0.77 percent.

Germany has had three deaths out of 1966 confirmed cases. That's 0.15 percent (presuming that I can still recall how to calculate percentages). Yet Trump has banned travel from Germany.

Norway has had 629 cases and no fatalities, yet Trump banned travel from Norway.

Latin America has had 222 cases and two deaths, for a fatality rate of 0.9 percent. Trump did not ban travel to and from South America. That situation may change soon, thanks to this embarrassment.

(Could Trump himself have been exposed? He didn't look well when he spoke to the nation from the White House last night.)

It is true that China has had a fatality rate of nearly four percent, if these figures are correct. The fatality rate in Italy is highest of all -- 4.25 percent as of four days ago. Looks to me as though the strain of the virus in those countries may be more dangerous than elsewhere.

Nobody ever called me an optimist, but isn't it possible that we've overstated the problem?

I mean, it seems likely to me that a lot of people may have had the coronavirus without realizing it. Many people may have presumed, as I have presumed, that their relatively "soft" illness was just another bout with the flu. Perhaps just a cold. If we learn that coronavirus cases are more widespread than current figures indicate, then the fatality percentages will go much lower. Perhaps they will end up on a par with the death rate for "normal" influenza strains.
Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, has said that the mortality rate for seasonal flu is 0.1 percent.
Now, I appreciate that Trump has suffered from the (no doubt correct) perception that his administration has mishandled this problem. You've probably heard that Trump fired the White House pandemic response team. That claim is rated as "true" by Snopes, but only "half-true" by Politifact. (Read both articles for the full details.) It is indeed true that Trump sought to reduce funding for the CDC, but Congress didn't go along with his plans.

Bottom line: Trump's history on health issues, coupled with his marble-mouthed statements, just plain looks bad.

Good. I'm just cynical enough to state that whatever makes Trump look bad in an election year is good news.

What's not so good is the possibility that you may lose your job due to an economic clampdown. What if you work for a movie theater? A sports arena? A restaurant? A school? A museum? An amusement park? A brothel?
@Joseph Glad you're back and feeling better.

My Corona, hahahaha.

I'm not a medical person, nor in public health. So, pretty much the usual not-so-well informed internet comment.

It seems worrying that healthcare workers appear to be getting sick in high numbers. Also that Travis AFB in northern California seems to have been a source of spread. If they can't control things in a military environment, it says nothing good.

“Here's the thing: It was all very low-level. I've had way worse tussles with influenza in the past, and so have you. If that was coronavirus, then what's the big deal?” That sounds like MAGAt or Matt Schlapp sort of thinking. Very disappointed in you falling for this logical fallacy. I didn’t get it or I didn’t die, so it must not be serious or dangerous.

1) You have no idea what you had. It could have been a flu, cold, infection, etc. I doubt it was cv.

2) We are all different. Two people with similar backgrounds and demographics may respond very differently to the same virus.

3) This at least twice as contagious as the Flu. For every person that gets the flu, they pass it on to another 1.1-0.9 people. The lowest number I have seen for cv is 2.1 and some estimates as high 3-5. The exponential growth of this is much higher than the seasonal flu.

4) Fatality rate is unknown, but almost certainly higher than the flu. The US doesn’t have enough beds or ICU beds compared to other nations. People compare us to nations like South Korea, Germany and Japan. They all have many more hospital beds 2-3 times more than US. We allegedly have more ICU beds, I seriously doubt it, I will expand later. All these numbers are based on hospital beds per 1,000 general population. I have studied Ebola, H1-N1, 1918 influenza outbreak. The number of cases of infection eventually peak, plateau, then end. The deaths from those infected are not know for days, weeks, months, years, and decades as our knowledge gets bettter. The mortality rate always goes up.

Here is an example. You have a small outbreak. The number shoots up to 20 infected cases, and keeps doubling every few days until it gets to 70. Then the growth slows and stops at 100 infected. 3 people are dead at this point. The news media reports a 3% mortality. However, there were still 12 people with in critical condition and 3 more die. The actual mortality rate was 6%. Now, imagine if those critical patients can get a bed, or ICU unit in time or at all. Then we have to triage. Only those with the best chance of survival get the needed care. That is why the mortality has spiked in Iran and Italy as the healthcare system is overwhelmed. The dreaded bugaboo of rationing creates actual death panels of frantic physicians and nurses make how to make the best of horrible situation.

5) Flu people have some immunization is built up over time. As well, we have vaccines that help slow the mortality and spread. Lastly, there is some herd immunity protection for vulnerable populations we don’t have for cv. Although, I have heard pneumonia vaccine does provide some protection in terms of helping people not get it while dealing with cv.

My father was hospitalized at the end of last year. I was walking through the hospital late at night, and I realized it was mostly empty. There were physical rooms, but they didn’t have the beds and supplies needed to adequately care for a patient. We are seriously f’d if we are expecting these empty ICU and regular beds to help patients in critical condition. I used to work in the medical field for over a decade. Our health system is a house of cards in my estimation.

If and when the numbers spike, the 80% that have moderate to mild symptoms are not the ones that are going to die and be at risk to die. It is those 20% that will have to ration ICU beds and respirators that are made in Chine and the EU. We didn’t have enough at the start of the year. Not sure how we ramp up to be where we need to be.

-C’est moi
Italy has a 6.7% fatality according to your link, 1,016 deaths out of 15,113 cases.

C’est moi
The elderly and those with reduced immune systems, diabetes and other ageing illnesses are especially vulnerable. If the infection becomes common then hundreds of thousands of them will present needing intensive support of one kind or another. In particular, machines that sustain heart and lung functions will often be required. The problem is these are in short supply. So that's no effective treatment for the most vulnerable and they will simply die in waiting corridors -- by the tens or, over time, hundreds of thousands. That's why the authorities are fighting to stop the general spread of the disease.
Thought this maybe interesting for Warren supporters
She's heeeeere...

We've just had our first few confirmed cases in the Arkanshire. I haven't actually counted, but I expect at least half the school systems have shut down already. Thank the Ascended Madoka, our Republican governor seems to have more sense, or at least more gravitas, than Benedict Donald.
Interesting take on Trump..........
We Need to Flatten the Curve. Trump and Fox Are Behind It.
by Jennifer Senior

"But Trump’s biggest crime Wednesday night was the short shrift he gave to what should have been his core message: Keep your distance. Yes, he mentioned it in passing, but only on the way to rah-rahing himself, denigrating foreigners, and announcing policies that terrified the markets. This was an opportunity to drive home, over and over again, the one message that practically every public health expert says is essential to stemming community spread, lest the pandemic overwhelm our hospitals. He had the command of all the big networks. Yet he didn’t.
Then again, it’s hardly a surprise. For Trump, the whole strategy of social distancing is a nightmare. It’s inimical to his political interests.
What last night’s address made clear is that Donald J. Trump is no one — and I mean no one, a naked-emperor nullity — without a crowd. Audiences are what energize him, give him his confidence, his king-size certainty; it’s at rallies that he A/B tests his ideas in real time. Without a press corps to troll or an adoring crowd to feed off, the man is a shell.
No wonder he was leaning on aides not to cancel recently scheduled campaign events in Colorado, Wisconsin and Nevada until the very last minute, and that his advisers had to prevail on him not to announce another rally in Florida, tentatively scheduled for the end of the month. As we saw Wednesday night, if you put him in a room with only a teleprompter and a camera, he can barely make it out of a sentence alive."
A comment by Missy in Texas
NYT Krugman article
"Ok here's what needs to happen. Biden and Bernie need to have a joint news conference, instead of the debate, they need to include members of congress (skyped in of course to avoid germs), they need to discuss the direction the country needs to go in, give helpful advise and calm the people down. I would do 2 hours of building the country up, not arguing between the two. Time for patriotism guys, and gals. How about calling on volunteers, if you have already had the virus and assuming you can't get it again, getting out there and helping the elderly, helping sick people. Lets do something positive."

Don't look down your nose at the Chinese - they are the experts on the virus - call it COVID-19 and you can capitalize the sucker. We have been put through the testing fiasco, which ultimately involves blood,testing and swabbing nasal, mouth and throat orifices.

Chinese researchers found that a one-step Chest CT with contrast, a routine imaging tool for pneumonia diagnosis, is fast and relatively easy to perform. This research found that the sensitivity of CT for COVID-19 infection was 98% compared to RT-PCR [throat swab test ] sensitivity of 71%. We have some number north of 11,000 machines doing 80 million scans each year in the United States, likely in a single 12-hour shift. So we have half a day unused.

But Chest CT scans cost about US $1,000 in the US and US $140 in the Netherlands. Blood, nasal, mouth-swab and other rapid tests cost less. However, providers paid through government CMS insurance programs receive only about 10% of charges made anyway - and the law on the books says that Uncle Sam pays for pandemic testing.

Why aren't we chasing CT scans?
Trump can ignore the elections and stay in office.
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