Switzerlands starts a large patient antibody test (blood sample) today. Let's hope it does work.

I own a small collection of chinese silk embroidered art work. The company I got it from (selling this artwork here in the us and around the world I believe) is offering direct shipment facemasks from their supplier in China. The prices offered seem reasonable, not a ripoff. I am thinking of ordering. Plus I have probably more Chloroquine than I would need (thanks SOT) If anyone is in need of these things let me know.

Today's totals for U.S. New Cases is 19,452. That's a factor of 1.04. Yesterday the factor was 1.09. That's good news. We are still headed off a cliff, but not as soon. Every week we delay the peak will save many lives. Hospitals will less overloaded. More masks and equipment will be available.

Let us hope this trend continues.

Other countries have also stopped the daily increase. Spain may have. It is actually down for the second day in a row. (Whereas the U.S. is up a little, but not as much as it was before.)

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

Until recently, the trend was relentless at 1.3. Here is the difference a steady 1.1 increase and 1.3:

By April 12 --

1.1 increase gives 803,435 cases, 81,256 daily increase

1.3 increase gives 4,353,862 cases, 995,668 daily increase

As I expect everyone can see, either number would be catastrophic, but 900,000 new patients is more than 10 times worse. It would mean only a tiny fraction of patients gets any treatment at all. 20% of patients need to be hospitalized. That's 200,000 people per day. Most would never get near a hospital. They would survive, or die, at home, with no better medical care than people afflicted by the black plague in 1347. The worst case estimate of the mortality rate is 3.5%, but that is assuming people get some level of hospital care. When there is no care, I do not know what the numbers would be, but some accounts from Italy indicate it would be 6% to 10%. In other words, 20,000 deaths per day, for many weeks, until natural immunity turns the curve down.

Comparing my simplistic spreadsheet to professional models, I find that around April 12 my spreadsheet departs far from reality, and becomes useless. Things would not be as bad as this. Still, according real models, we might be looking at hundreds of thousands of new cases per day.

My spreadsheet is wrong for April 12, but the gigantic difference it shows from different exponents is real. That is why professionals estimate the total death toll at anywhere from ~300,000 to several million. It all depends on the rate, and the rate can only be reduced by staying at home and social distancing. There were much better alternatives, but the government never even tried them, and it is too late now. We cannot escape many thousands of deaths per day for weeks, perhaps months. A 9/11 attack every day, only this time, everyone saw it coming. Let us hope it is not hundreds of thousands of deaths a day. It might be. The experts all say they cannot predict what will happen. They say only that if we do not shelter in place, it will be far worse.

Quote from JedRothwell

Today's totals for U.S. New Cases is 19,452. That's a factor of 1.04. Yesterday the factor was 1.09. That's good news. We are still headed off a cliff, but not as soon. Every week we delay the peak will save many lives. Hospitals will less overloaded. More masks and equipment will be available.

Let us hope this trend continues.

Other countries have also stopped the daily increase. Spain may have. It is actually down for the second day in a row. (Whereas the U.S. is up a little, but not as much as it was before.)

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

Until recently, the trend was relentless at 1.3. Here is the difference a steady 1.1 increase and 1.3:

By April 12 --

1.1 increase gives 803,435 cases, 81,256 daily increase

1.3 increase gives 4,353,862 cases, 995,668 daily increase

As I expect everyone can see, either number would be catastrophic, but 900,000 new patients is more than 10 times worse. It would mean only a tiny fraction of patients gets any treatment at all. 20% of patients need to be hospitalized. That's 200,000 people per day. Most would never get near a hospital. They would survive, or die, at home, with no better medical care than people afflicted by the black plague in 1347. The worst case estimate of the mortality rate is 3.5%, but that is assuming people get some level of hospital care. When there is no care, I do not know what the numbers would be, but some accounts from Italy indicate it would be 6% to 10%. In other words, 20,000 deaths per day, for many weeks, until natural immunity turns the curve down.

Comparing my simplistic spreadsheet to professional models, I find that around April 12 my spreadsheet departs far from reality, and becomes useless. Things would not be as bad as this. Still, according real models, we might be looking at hundreds of thousands of new cases per day.

My spreadsheet is wrong for April 12, but the gigantic difference it shows from different exponents is real. That is why professionals estimate the total death toll at anywhere from ~300,000 to several million. It all depends on the rate, and the rate can only be reduced by staying at home and social distancing. There were much better alternatives, but the government never even tried them, and it is too late now. We cannot escape many thousands of deaths per day for weeks, perhaps months. A 9/11 attack every day, only this time, everyone saw it coming. Let us hope it is not hundreds of thousands of deaths a day. It might be. The experts all say they cannot predict what will happen. They say only that if we do not shelter in place, it will be far worse.

Display More

Speaking to someone smart today about the growth slowing, he just said social distancing is working, slowly but surely. We just have to keep doing it for a while. Now is not the time to let up. Separation is the key to slowing it down.

https://finance.yahoo.com/news…eaningless-123550415.html

"Confirmed Coronavirus Cases Is an ‘Almost Meaningless’ Metric …….“The numbers are almost meaningless,” says Steve Goodman, a professor of epidemiology at Stanford University......What should we be watching instead? One possibility is hospitalizations.....They argue that rate of increase in hospitalizations could reflect the growth of the disease without being distorted by changes in the testing rate......Measuring death rates can eventually track the speed with which Covid-19 is spreading — as deaths represent a fraction of cases. But there’s a lag of some three weeks between infection and death......Random sampling would help too"

https://www.bloomberg.com/opin…almost-meaningless-metric

Quote from Wyttenbach

Switzerlands starts a large patient antibody test (blood sample) today. Let's hope it does work.

Some don't but some do, that's good news. At my lab in Geneva we already tested many patients using various antibodies assays. Rapid tests are crap but some ELISA are good.

The prevalence remains low. Most surprising is that the immune system is reacting fast with IgG already elevated only a few days after symptoms onset. Which is also good news.

Quote from oldguy

https://finance.yahoo.com/news…eaningless-123550415.html

"Confirmed Coronavirus Cases Is an ‘Almost Meaningless’ Metric …….“The numbers are almost meaningless,” says Steve Goodman, a professor of epidemiology at Stanford University......What should we be watching instead? One possibility is hospitalizations.....They argue that rate of increase in hospitalizations could reflect the growth of the disease without being distorted by changes in the testing rate......Measuring death rates can eventually track the speed with which Covid-19 is spreading — as deaths represent a fraction of cases. But there’s a lag of some three weeks between infection and death......Random sampling would help too"

https://www.bloomberg.com/opin…almost-meaningless-metric

Indeed. Almost meaningless. "Confirmed Coronavirus cases" is more a metric of the testing frequency than anything else. A better metric (but still not necessarily good) is the number of deaths in a village or region in comparison with the previous years. For example in the north of Italy, a village has already had 158 deaths from Jan 1st 2020 while the average of the previous years at the same time of the year is 35, with small year-to-year variations around that average. Therefore we can safely conclude that about 120 deaths can be attributed directly or indirectly to the pandemic in that village. (Not saying that the official number of deaths caused by COVID-19 was only 31 for that village...). The takeaway message is that all official stats should be taken with a grain of salt.

Quote from Shane D.

Just for clarification; this latest French study I posted today is new. The report this Statnews article references was the earlier study. Gautret is the lead author for both. As they, and many other critics pointed out, the first left much to be desired. Mainly because 6 of the 20 taking the HCQ dropped out.

I am not sure if this new study is superior to the last, but it covered 80 patients (6 from the earlier study) during a 3 day period, with 6 day follow up. 78 clinically improved, with the viral load decreasing rapidly.

I am no medical researcher, but that sounds very promising to me. Any reason not to be optimistic?

There was no control here. The comparisons with patient recovery time in Wuhan don't mean anything unless we know that the severity of cases is the same in the two groups. How do we know that without the drugs these patients would not have these recovery times? We don't. So while that second study is interesting and positive, it did not add anything to the evidence base.

All that is needed is a smallish randomised controlled trial (preferably but not necessarily double-blind) and the evidence base is a lot stronger. Another week or three I guess before we know more.

If it makes people happy to believe the evidence is much stronger than that on basis of tests seen so far then let them be happy, but that does not make it true.

I hope very much that the Marseille patients are comparable with the Wuhan ones. In that case the evidence would be very strong. The paper would have to look at the relative admission characteristics of the two sets and compare them to even estimate that.

Quote from JulianBianchi

Indeed. Almost meaningless. "Confirmed Coronavirus cases" is more a metric of the testing frequency than anything else. A better metric (but still not necessarily good) is the number of deaths in a village or region in comparison with the previous years. For example in the north of Italy, a village has already had 158 deaths from Jan 1st 2020 while the average of the previous years at the same time of the year is 35, with small year-to-year variations around that average. Therefore we can safely conclude that about 120 deaths can be attributed directly or indirectly to the pandemic in that village. (Not saying that the official number of deaths caused by COVID-19 was only 31 for that village...). The takeaway message is that all official stats should be taken with a grain of salt.

As long as countries have a consistent policy for who they test (e.g. all people admitted to hospital with symptoms) and consistent policies for who is admitted then the case number is good for showing change in incidence within a country, though not comparable with other countries and no good for working out overall level of infection. But under stress of many cases policies stop being consistent - for example when you have more patients than tests available.

Death rates are much better, although they can be contaminated by home deaths not counted, or non-COVID deaths counted (the latter is less likely perhaps).

Death rates do lag cases by 2-3 weeks or so, but make the best comparison we have between countries.

Random sample testing is ideal but difficult to do and for countries with not enough testing capacity you can't afford to do it. the UK at the moment cannot test all front-line medical staff - ridiculous.

There is evidence for equine corona virus infection, I hope your horse doesn't become ill.

Trump facing critical choice on coronavirus measures

https://www.cbc.ca/news/world/…avirus-measures-1.5513607

Quote from Max Nozin

Now imagine what the death rate would be if only few out of 6% do not get proper care?

After the extended French study that used dirty cheap generics there is no reason to be afraid of a high death toll. It's all matter of organization now and may be a strong kick in the ass of some big Pharma bullies (Gillead) is needed too.

Both generics have been tested at least at 1 billion of patients are among the most trusted medicaments. Only a small set of patients needs more specific treatment.

Most patients could in fact be sent to isolation at home ( last after 2 days) with the medication to free space for the exceptions.

I think that the lockout can be ended in regions that put in place the correct treatment with enough stock of medicaments and test-kits.

Quote from JulianBianchi

Indeed. Almost meaningless. "Confirmed Coronavirus cases" is more a metric of the testing frequency than anything else. A better metric (but still not necessarily good) is the number of deaths in a village or region in comparison with the previous years

Other experts disagree. Yes, in many countries the confirmed cases are only a fraction of the total, but they are still useful. They show the trends, and the distribution. They show that New York City and Albany, Georgia are hot spots. They are only fraction of total cases, but they are probably a consistent fraction, in one country.

In Japan they are nearly 100%, because every patient goes to the hospital, even mild cases. Some people don't know they have it, but the government jumps through hoops to trace the known cases and find people who have mild cases. On the news every night they list all cases, and show how many cannot be traced (usually 4 or 5). In Korea, probably 90% or more are registered with public health agencies. In the U.S., no one knows, because we still do not have test kits or nurses to administer them. In Atlanta, people who are sick are told not to go to the hospital, because there is no room and if you are not infected, you may well be at the hospital.

When you have some idea what the ratio of confirmed cases is to total cases, you can draw conclusions. You can also combine this metric with others, such as "the number deaths in a region in previous years." Together, these combined methods give a reasonably clear picture of what is happening.

When you have no testing, no functioning public health system, no way to visit hospitals, and no government coordination, you might as well be back in the 14th century. That is more or less where we are in Atlanta, GA today. If you manage to get in the door at the hospital, you are back in the 21st century. Although, it may soon be the Northern Italian version of the 21st century, with 6% (??) case fatalities, given how many fat and unhealthy people there are in Atlanta, and how overcrowded our hospitals will be.

This epidemic can only be controlled when the public is educated, informed, generally in good health, and when it has faith in science and the medical establishment, and when it cooperates. That is the situation in Japan, and the government is doing all it can to keep things that way. There was a spike of about 200 new cases the other day, which put the fear of God into everyone. P.M. Abe who came on national news telling people not to relax, and that the country might still see explosive, uncontrolled growth "like Europe and the U.S." 40 of the cases originated in one hospital. That's good, because a pin-point source makes it easier to track down other people who may have been infected.

Unfortunately, the U.S. public does not meet any of those criteria; it is not educated, informed, healthy, and it has practically no knowledge or faith in science. The Italian public was also notably uncooperative until recently. People in Italy now say they deeply regret not taking this seriously, and not doing what the government recommended weeks ago.

Wyttenbach - what, send patients home with a supply of HCQ, Azithromycin, Zn and remdesivir if it is available from Gilead or Avgen from China? The problem here is that the government and NHS will not do anything so easy without WHO approval. We have to wait , and wait even in the light of all the positive evidence so far. My son seems to have had just a mild dose of COVID-19 and is recovering having drunk large amounts of tonic water for its Quinine content. I 'm afraid it's up to the individual to weigh up the evidence and decide which possible treatment might work or not. Here's a list of what we've been routinely taking for prophylaxis:

Tonic water (20 mg/ml quinine) - evidence that it accumulates in the body to prophylactic levels (10 uM) over several weeks.

Coconut oil 1-2g - contains Lauric acid and forms monolaurin in the body which blocks endosomal fusion limiting viral replication.

Liquorice extract -liquorice allsorts as much as you can eat anti-virus agents as oldguy pointed out. Good source of thiamine which can be depleted by quinine use.

Echinacea anti viral herbal remedy prevents colds & flu.

Vitamins C 1g , multivitamin + Vit D+.Ca.

Broccoli, baked beans, black or green tea for flavonoids.

Blueberries strawberries, tomatoes for anthrocyanins.