Covid-19 News

    Quote from seven_of_twenty

    Good article about various hydroxychloroquine and chloroquine studies with and without azithromycin. Why in the world would one not include azithromycin?

    It may be behind a sign up wall but Medscape is free and you can fudge answers to the questions when signing up.


    https://www.medscape.com/viewarticle/927758


    This, posted here by RB initially, although a preprint is a serious study 31+31 patients randomised controlled and (it seems on the study ticket) double-blind. Much, much better quality than the studies noted in the medscape review (preprint date was 30 march so they just missed it).


    Very significant highly positive results. Only issue is this is for treatment from an initial mild presentation, so it does not show this will work for cases already acute when get to hospital.

    Quote

    This, posted here by RB initially, although a preprint is a serious study 31+31 patients controlled and (it seems on the study ticket) double-blind. Much, much better quality than the studies noted in the medscape review (preprint date was 30 march so they just missed it).

    What? Maybe missing link? Or I didn't have high enough blood caffeine level to understand the post?

    Quote from Alan Smith

    The difference this time is that there is no war work, no wages, and no handouts for the next few months. No pubs, restaurants, cinemas, hairdressers, builders, gardeners, window cleaners. taxis, a very long list. And those people will have no money very soon. That never happened in WW2.


    My point is that "war work" does not actually contribute to the economy. It is a waste of labor and materials. Of course it is necessary, but when you are finished, there is nothing left but a pile of scrap metal and dead people, rather than useful things people want to buy. There is not much "army surplus" that people want to buy. There was no use for the 150,000 airplanes left over. They were melted down for scrap, which was worth a tiny fraction of the cost of making them. So, from the economics point of view, war work is like paying people to dig holes in the morning and fill them up every afternoon. Or like paying people to sit at home playing video games. That being the case, the government today should now pay nearly everyone to sit at home. It should pay about the same as WWII war wages.


    During WWII in the U.S. there was a long list of jobs not filled, such as taxi drivers, autoworkers, switchboard operators and builders. Civilian home and building construction came to an abrupt halt. Not a single car was manufactured for the civilian market. Every car and truck that was made was sent to the army or lend lease, mainly to Russia. Many ended up abandoned or as scrap in Europe and the pacific.


    In other words, large segments of the economy were stopped dead. Only essential services and manufacturing were allowed. That is exactly the situation today. We have food production, electricity, water and essential transportation, but not much else. Life during WWII shows that we can live with this, for years if necessary. Certainly for months. It will not harm the economy. It will not cause inflation or devalue the money either, as long as the government collects as much as it spends in taxes. That is more or less what it did during WWII, and continuing after for about 10 years, with very high tax rates. We need very high tax rates, especially on rich people, for a while. It is a small price to pay to ensure that everyone has enough to eat, and people are not evicted from their houses and apartments.

    • Official Post

    JedRothwell


    I agree that war work does not contribute to the economy, but people got paid to do it- on fact war work was almost like paying everybody a basic income -helicopter money. Nothing like the current situation Some people here in the UK will (eventually) be paid to do nothing, but for many of them it will only be $120 a week. Not enough to starve on.


    If a significant portion of the 'would be consumer' population have no money, the economy will crash. The richest person can only wear one pair of shoes at a time, and eat 3 meals a day, thus their personal contribution to a prosperous economy in terms of purchases is is really very small, even if they do buy their jockstraps from Tiffany. An economy can only thrive by putting money into everybody's pocket, that is the mark of a first-world economy. When that is not the case, you end up like (for example) Madagascar, where wealth is concentrated into the hands of a few and consequently the poor never see any.

    https://www.snopes.com/fact-ch…669-coronavirus-patients/


    Snopes.com has reviewed the claims of Dr. Zelenko-- remember him? Claimed he treated 667 patients with hydroxychloroquine and azithromycin and zinc and got no complications, hospitalizations or deaths? Snopes says: unproven. I would add: improbable unless he treated everyone who had sniffles or a cough.


    And a request/suggestion to all: if you post a link, please describe it just a little in the post unless the subject matter is obvious from the link itself.

    "

    Quote from RobertBryant

    perhaps I am misinterpreting this..

    i am misinterpreting it..

    "

    https://www.fredhutch.org/en/n…id-19-trevor-bedford.html


    "How fast is the virus mutating?

    The rate looks to be about 24 mutations per year. Coming back to the game of telephone, that’s a mistake every second or third transmission. This rate of two mutations per month is similar to other RNA viruses like flu. This coronavirus has a longer genome than flu,

    so there are fewer mutations per base.

    None of the COVID-19 mutations look particularly interesting, but there a few things to watch for though.

    One is for mutations in the spike protein, which will be important for a vaccine.


    Trevor Bedford has an educational thread about 100s' of strains..


    @trvrb · 25 Mar I'm writing this thread because I have a bunch of mentions talking about 100s of "strains" and no ability to vaccinate against them. I want to clarify scientific usage of strain vs mutation. 2/12


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    Quote from Alan Smith

    I agree that war work does not contribute to the economy, but people got paid to do it- on fact war work was almost like paying everybody a basic income -helicopter money. Nothing like the current situation


    My point is that we must pay people to sit at home. We need a basic income -- right now, this month. At least for the duration of the pandemic. Without that, we are in deep trouble economically and socially.


    I am not saying we will get through this with no deep economic damage. I am saying there is a model for getting through without economic damage: World War II. This should be handled like a full scale war, except that instead of paying people to make airplanes, we should pay them to sit at home.


    I am also saying we can go without many segments of the economy for months. Even years, if necessary. We can stop building houses and stop manufacturing cars for three and half years, and still be okay. That's what happened from 1942 to 1945. Demand was pent up, but people muddled through.

    • Official Post

    https://www.thelancet.com/jour…-3099(20)30243-7/fulltext


    From an extensive analysis of data from different regions of the world, our best estimate at the current time for the case fatality ratio of COVID-19 in China is 1·38% (95% CrI 1·23–1·53). Although this value remains lower than estimates for other coronaviruses, including SARS

    24 and Middle East respiratory syndrome (MERS),25 it is substantially higher than estimates from the 2009 H1N1 influenza pandemic.26
    , 27
    Our estimate of an infection fatality ratio of 0·66% in China was informed by PCR testing of international Wuhan residents returning on repatriation flights. This value was consistent with the infection fatality ratio observed in passengers on the Diamond Princess cruise ship up to March 5, 2020, although it is slightly above the upper 95% confidence limit of the age-adjusted infection fatality ratio observed by March 25 (of 712 confirmed cases, 601 have been discharged, ten have died, and 11 remain in a critical condition). This difference might be due to repatriation flight data slightly underestimating milder infections, or due to cruise passengers having better outcomes because of a potentially higher-than-average quality of health care.

    Our estimates of the probability of requiring hospitalisation assume that only severe cases require hospitalisation. This assumption is clearly different from the pattern of hospitalisation that occurred in China, where hospitalisation was also used to ensure case isolation. Mortality can also be expected to vary with the underlying health of specific populations, given that the risks associated with COVID-19 will be heavily influenced by the presence of underlying comorbidities.

    Our estimate of the case fatality ratio is substantially lower than the crude case fatality ratio obtained from China based on the cases and deaths observed to date, which is currently 3·67%, as well as many of the estimates currently in the literature. The principle reason for this difference is that the crude estimate does not take into account the severity of cases. For example, various estimates have been made from patient populations ranging from those with generally milder symptoms (for example international travellers detected through screening of travel history)

    13 through to those identified in the hospital setting.14
    , 15

    It is clear from the data that have emerged from China that case fatality ratio increases substantially with age. Our results suggest a very low fatality ratio in those under the age of 20 years. As there are very few cases in this age group, it remains unclear whether this reflects a low risk of death or a difference in susceptibility, although early results indicate young people are not at lower risk of infection than adults.

    28
    Serological testing in this age group will be crucial in the coming weeks to understand the significance of this age group in driving population transmission. The estimated increase in severity with age is clearly reflected in case reports, in which the mean age tends to be in the range of 50–60 years. Different surveillance systems will pick up a different age case mix, and we find that those with milder symptoms detected through a history of travel are younger on average than those detected through hospital surveillance. Our correction for this surveillance bias therefore allows us to obtain estimates that can be applied to different case mixes and demographic population structures. However, it should be noted that this correction is applicable under the assumption of a uniform infection attack rate (ie, exposure) across the population. We also assumed perfect case ascertainment outside of Wuhan in the age group with the most cases relative to their population size (50–59-year-olds); however, if many cases were missed, the case fatality ratio and infection fatality ratio estimates might be lower. In the absence of random population surveys of infection prevalence, our adjustment from case fatality ratio to infection fatality ratio relied on repatriation flight data, which was not age specific. The reported proportion of infected individuals who were asymptomatic on the Diamond Princess did not vary considerably by age, supporting this approach, but future larger representative population prevalence surveys and seroprevalence surveys will inform such estimates further.

    Much of the data informing global estimates of the case fatality ratio at present are from the early outbreak in Wuhan. Given that the health system in this city was quickly overwhelmed, our estimates suggest that there is substantial under-ascertainment of cases in the younger age groups (who we estimate to have milder disease) by comparison with elsewhere in mainland China. This under-ascertainment is the main factor driving the difference between our estimate of the crude case fatality ratio from China (3·67%) and our best estimate of the overall case fatality ratio (1·38%). The case fatality ratio is likely to be strongly influenced by the availability of health-care facilities. However surprisingly, although health-care availability in Wuhan was stretched, our estimates from international cases are of a similar magnitude, suggesting relatively little difference in health outcome. Finally, as clinical knowledge of this new disease accrues, it is possible that outcomes will improve. It will therefore be important to revise these estimates as epidemics unfold.

    The world is currently experiencing the early stages of a global pandemic. Although China has succeeded in containing the disease spread for 2 months, such containment is unlikely to be achievable in most countries. Thus, much of the world will experience very large community epidemics of COVID-19 over the coming weeks and months. Our estimates of the underlying infection fatality ratio of this virus will inform assessments of health effects likely to be experienced in different countries, and thus decisions around appropriate mitigation policies to be adopted.

    Quote from Deleo

    Not a great day for us here in the U.S. numbers wise. Several states now at over 1k new cases per day.


    That's what I said some days ago. The New York lock down did tease the real numbers of the other states that now are in a very strong exponential growth.


    Three weeks ago I said that the USA should stop all flights and cut the interstates for private traffic. Now its to late. All states are in now the Italy situation. But if they have no smog and a healthy population the outcome will be similar to Germany or Switzerland with a very low rate of critical (ICU) cases. But mortally of delivered patient is everywhere above 1% and thereof 99% did have a least one medical preconditions.


    Thus the ultimate thing to do is to strictly isolate all people with preconditions. This will be almost impossible for some states but then they should distribute the appropriate medication and not at all believe what US big pharma tries to tell. Anti viral medicaments, even the best ones, cannot help in about 50% of the ICU cases. Thus try to avoid this situation by early medication and isolation of the most vulnerable.

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