Covid-19 News

    Quote from THHuxleynew

    Stefan, I'd be interested in this if real but I bet you it is not. I can't find any research that argues Sweden COVID IFR is 0.1%. Perhaps you could link it? What you quote (and I'd like the evidence and sample from which this was determined) does not prove that. You need to be sure that those who "don't know they are infected" stay asymptomatic after they are tested. Many of them will not.


    PS - they have a policy of shielding older people. If they do this really well then IFR 7X lower than the current estimate 0.66% is very possible just based on the fact that only young and healthy people catch it. Risk double with every 7 years age increase.

    This is news touted by the authority FolkHälsomyndigheten. If you want source code I think it's possible to get it. Unfourtunately in swedish.

    Math Study

    Quote from Shane D.

    No matter what you think, or say, the states are going to open up, so get over it. They have no choice.


    Of course they have a choice! They can do what Massachusetts and Maryland are doing, which is what Johns Hopkins recommended. These states have hired 1,000 people to monitor and trace cases, and put in place comprehensive testing. If the daily new cases continue to fall, in a few weeks these states will be safe to re-open. States which do not take these steps will not be safe. Georgia is not doing any of these things. Georgia is so bad, the health department cannot even keep track of deaths, never mind cases. No one has the slightest idea how many cases there are. Test kits are still so rare, even dead patients are not tested. The governor bragged that we now have a drive in test site. One test site. For the whole of Atlanta, 5.6 million people. By appointment only.


    Georgia is no more ready to deal with this pandemic than than Iran is. For Georgia to re-open now, with virtually no testing, no serology testing at all, no means of monitoring or quarantining, does not invite a resurgence. It ensures a resurgence. How bad it will be depends on how stupid the population is. If the population follows through and it is as stupid as the governor, that will wreck our economy for years to come. You say you want to preserve the economy and protect jobs? Then why are you advocating policies that will have exactly the opposite effect? You should advocate doing what the experts at Johns Hopkins and in Korea have recommended. That is probably the only way to prevent a years-long depression.

    Fortunately, there are local officials in Georgia who understand what must be done. Here is what a Dekalb County Commissioner wrote:



    [W]hat Governor Kemp is proposing is dangerous. Friday is too soon to begin that process. For starters, all the Pubic Health experts agree that in order to keep corona spikes from breaking out, we need universal testing and we need thousands of “contact tracers” to contain potential new cluster outbreaks. Right now, we have neither.


    In fact, the numbers on testing should worry everyone. Only 90,000+ tests have been administered here in Georgia with a population of 10,000,000+.

    Here in DeKalb County, our Medical Reserve Corps is recruiting volunteers right now and currently has signed up over 200 people. But we will likely need thousands to implement a large scale contact trace program . . .



    [If you are in Georgia, and you are qualified to join the Medical Reserve Corps, click on that link to join.]

    Quote from THHuxleynew

    Shame. Google translate does not make this comprehensible alas.


    https://www.medrxiv.org/conten….20066050v1.full.pdf+html


    Tom Britten. Modelling, does not attempt to determine the IFR.

    No I think that the swedish reoport is more interesting. The divided the population in compartments where one was mild conditions the dark fraktion and the other group severe symtoms and seen bu the publoc health. Also they speculate that there is different rates of spreading from the two groups. They also calibrated with a study of the number of infected at a weak in march. The studied 3 scenarious one where the dark group was 99% and for this group the spreading was the same as in population this was the best fit. now if you think about it 99% should determin the spread. Also 99.5% and 99.9% figures was tested but then a lower fraction of spreading was in the dark group. As you can see these is confounding factors and indeed if you look at the graphs there is not much difference. but the best error was from 99.9 whic is known to be a wrong answer and the presenter made a little fool of himself mensioning this number. As I said before the spread should be determined by the dark big group and therfore 99% seams right to me. Any how from reported cases to death there is another factor of 10 that gives 0.1%

    Quote from stefan

    ... Anyway there is not much evidences for COVID to be spread by kids.


    I heard the same thing yesterday, in this video interview with (now retired?) Swedish epidemiologist Dr. Johan Giesecke

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    Quote from Alan Smith

    The USA has lower life expectancy, higher infant mortality


    I shudder every time I read that. Those are dreadfully poor measures of health care quality. They are more measures of ignorance, bad habits and perhaps genetics of the population under study. Infant mortality, for instance, is made worse by neglect of prenatal care. That is far more common among uneducated people of which we have, in the US, way too many. Remember, you can get almost any result you want with statistics.

    Quote from seven_of_twenty

    The USA has lower life expectancy, higher infant mortality . . .


    I shudder every time I read that. Those are dreadfully poor measures of health care quality. They are more measures of ignorance, bad habits and perhaps genetics of the population under study.


    Ignorance and bad habits are a measure of education and public health. In the 1960s, children in public schools (including me) were taught good eating habits, such as a balanced diet. We were told we should not get fat. We were not allowed to have soft drinks except on special occasions because "they rot your teeth." In Europe and Japan they still teach that. But in many U.S. schools, they no longer teach it. The children and their parents do not know about basic nutrition. Some of them do not recognize vegetables such as potatoes and onions. This was shown in a TV special by Jamie Oliver. People do not know things by ESP; they have to be taught.


    Genetics cannot be the cause of these problems. The U.S. white population is genetically the same as the European population. The U.S. used to have longer life expectancy and lower infant mortality than the EU, but today it is worse. The genetics have not changed.


    Quote from seven_of_twenty

    That is far more common among uneducated people of which we have, in the US, way too many


    Exactly. As I said, that is a failure of public education and public health, which are closely connected. In the U.S., we used to have the best schools, the best public health and hospitals in the world. Then, from the 1970s on, our leaders made political decisions let our education and public health systems gradually degrade in quality, in poor districts. (Wealthy school districts are as good as ever.) We decided not to invest in the education, health and wellbeing of citizens as much as our economic rivals in Europe and Asia are doing. Now we are reaping the fruits of those policies.


    American people were not fat and unhealthy in the 1960s. Look at any photo of a crowd, and you will see they were as healthy and thin as Europeans are today. There has been no genetic change. What happened is obvious to any public health expert or anthropologist. Our "foodways" (diet and eating habits) changed. We stopped teaching children how to eat a healthy diet. Those children grew up to be ignorant, fat and unhealthy, and they raised a generation of children who are even worse. So now we have 40% of the adult population overweight or obese. Hundreds of authoritative books and studies describing this have been published. The problem is obvious to any public health expert. So are the solutions, since we did not have this problem in the past, and they do not have it in Italy, Japan or other first-world countries. Political leaders do not wish to do anything about it, just as they did not wish to fix air pollution in the 1950s, or cigarette smoking in the 1960s.

    Quote from RobertBryant

    Of course ,the Wuhan records have been smoked..


    Not really. The Chinese CDC recently updated the totals, adding thousands of cases and deaths. The chaos at the beginning of the epidemic made the numbers difficult to collect.


    In Georgia, the actual number of patients and deaths, and the locations of both, are being covered up by the authorities, the hospitals, and especially nursing homes. Allegedly to prevent "panic." See:


    https://www.ajc.com/news/state…k/eRBs5mrNagETnpr6ZGejzM/

    People in Georgia have been wondering why the governor is opening "body art studios, barbers, cosmetologists, hair designers, nail care artists . . ." and other strange choices. Any doctor would say these are the last people who should go back to work, long after the epidemic ends. It turns out there is a good reason for including them on the list. An Atlanta journalist friend described it. Body art studios, barbers, and the others are licensed. Therefore, they are eligible for unemployment benefits, when the government orders them to close. Most of the people working in these jobs are poor and minorities. So, my friend explained:



    "If there's no state order calling for businesses to be closed, the people who are unemployed can no longer claim that their unemployment is involuntary, even if it would be utter idiocy for them to return to work. A hair dresser or a massage therapist cannot maintain social distance. But they can certainly file for relief ... unless the law says they can work.


    'Gyms, fitness centers, bowling alleys, body art studios, barbers, cosmetologists, hair designers, nail care artists, estheticians, their respective schools & massage therapists.'


    Not banks. Not software firms. Not factories. Not schools."



    . . . In other words, by saying these places can open, the governor denies these workers unemployment benefits. And, indeed, several of them have gotten letters mailed on April 16 saying their application for benefits were denied, including many who never applied for benefits. Because they are mainly poor and minorities, they have no political influence; they cannot reverse this decision; and their plight will not be reported in the Atlanta Journal or on CNN. In other words, they are an easy target.

    decline-treatment.jpg

    IF YOU PROTEST A LOCKDOWN IN A STATE WITH AN UPGOING CASE VS TIME CURVE, SIGN AND CARRY

    PUT YOUR CONVICTION WHERE YOUR MOUTH IS


    From a critical care physician whose research fellowship was interrupted and who now cares for

    extremely sick (and hazardous) patients at the University of Arizona at Phoenix


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    nurse-defiant.jpg


    ECMO, ICU AND VENTILATOR R.N. AT A MAJOR HOSPITAL TREATING COVID-19 CASES


    Her friend and colleague wrote:


    She is a good friend and an ECMO/ICU nurse at my hospital. She is one of our best. An incredibly kind human and a badass nurse. Today she stood up for healthcare workers as protestors descended upon the State Capitol. She stood in silence as people called her a ‘fake nurse’ & ‘paid actor’ amongst other horrendous things. Ironically, she has spent many days in the Covid ICU caring for our sickest patients. She stood for those who are on life support and have no voice of their own. She stood for the 42,604 Americans who have died so far. She stood for her colleagues; nurses, therapists, techs, janitorial staff, doctors and security amongst others. She stood up for those very protestors who hurled obscenities at her. When they inevitably contract Covid-19 and transmit it to their loved ones, Lauren will be one of the first faces they will see when they are admitted to the ICU. She may also be one of the last faces that they ever see. When in their ignorance and hubris, they have caused the demise of their own mother or father, Lauren will be standing in silence next to them yet again, this time in mourning. She made us all incredibly proud today.


    We extend an invitation to those who believe that they are being stripped of their civil liberties or that this is a giant hoax or that healthcare workers and the media are sensationalizing this pandemic for our own vested interests. To those who would turn a global pandemic into a twisted partisan issue. To those who foolishly believe that this virus discriminates based off of political ideology, race, religion or creed. We invite you to come spend a day in our Covid ICU with our nurses, therapists and physicians. You will spend the day wearing an n95 mask which will pretty much cut off circulation to your face. Don’t worry, you will get used to the sensation after a while. You’ll also get used to the dull constant headache that becomes a fixture after you have spent the day rebreathing CO2. You will learn how to don and doff PPE each time you interact with one of your patients. You will learn to live with the constant uncertainty of wondering if you have already caught the virus. If tomorrow will be the last time that you see your loved ones for the immediate future because you will need to start self quarantining. You will learn the familiar subtle change in tone of the code bells prior to a ‘Code Blue’ being called on the overhead. As you rush into a strangers room, you will gaze upon their lifeless eyes and blue lips. You will frantically begin to perform CPR, painfully aware of the fact that with each chest compression, you may potentially be aerosolizing the virus. You will watch as we place invasive central lines, arterial lines and chest tubes. You will stand at the head of the bed with us while we intubate a Covid-19 patient, inches away from their mouth, always cognizant of the damage that can be done with just one cough. You will stand next to us when we tell a husband over the phone that his wife has passed away, surrounded by strangers in space suits. The worst part of it all, he will not be allowed to see the love of his life to say he loves her one last time because of the infection risk it poses to him and other members of the public. You will stand in silence as you listen to another human express the deepest level of anguish possible, the tone of his cries seared into your memory.


    Perhaps then you will understand.

    XRAYS.jpg


    "These chest x-rays were taken 8 hours apart. On a relatively young, healthy, tough as nails veteran. When I assessed him in the ED initially, he looked great, sitting up in his bed, talking in full sentences. Texting on his phone. In the ICU, we refer to that as the ‘cellphone sign’. I thought to myself that he could probably be admitted to the ward as a COVID-19 rule out. Then I saw his admission CXR and told my charge and lead RT that I wanted him in the ICU in the next ten minutes and that we need to intubate him. I told him what was going on, he looked at me in disbelief when I told him that he was very sick and needed to be intubated. “ I feel fine doc, I just have the flu”. By the time i finished the cumbersome ritual of getting my PPE and PAPR on, his sats were in the high 80’s on a non rebreather mask. I knew we had no time. I intubated him immediately, the familiar change in tone on the monitor of dropping sats to the low 80s, then 70s, then 60s before recovery. He had zero reserve. Eight hours later, he was maxed out on conventional ventilator settings and I couldn’t get his sats above 85%. Now on APRV, inhaled nitric oxide with plans to begin proning, I’m still in disbelief with how quickly he deteriorated.


    As a pulmonary and critical care fellow at a busy academic center in a large metropolis, I’m used to seeing critically ill patients. ECMO, transplant, PH, ILD, MCDs, high risk OB are things that I have become intimately familiar with. We deal with the sickest of the sick and my team does it very well. Death is an ever present companion for us. Yet, COVID-19 is unlike anything we’ve ever come across. Therapies such as plaquenil/azithromycin (flawed study), Kaletra (negative study), Actemra, Remdesivir do not have strong data (as yet). Steroids likely make these patients worse based off data extrapolated from the MERS/SARS cohorts. As of now, all we can do is provide supportive intensive care and try to mitigate the cytokine storm. Oh I forgot to mention that a large amount of patients seem to be dying from sudden cardiac death/acute cardiogenic shock, presumably secondary to viral myocarditis.


    It doesn’t just affect the elderly. It affects everyone. Young people are dying too. It breaks my heart to see the casual attitude of society towards this pandemic while my colleagues and I work day after day without respite. I consider myself lucky to work with some of the most talented and bravest physicians, nurses, RTs and ancillary staff that I have ever met. We all know and accept the risk that comes with this job. I am cognizant that I will likely get COVID-19 during the next few months. I also know that my mortality risk is relatively low. This is a risk I fully accept. Many of my colleagues have a higher risk. They have demonstrated an unwavering commitment to the job regardless. We don’t want sympathy. We don’t want thoughts and prayers. We don’t want you to change your profile picture in solidarity with us. What we want is appropriate and adequate PPE. We want ventilators. We want for every citizen to do their part to flatten the curve. We want mass screenings. We want to be able to test patients based off of our years of training and clinical judgment. Not because some suits in admin decided that these patients didn’t meet some vague criteria decided upon by folks who have no idea what it’s like to be in the trenches. There are no high risk or low risk patients anymore, everyone should be presumed COVID-19 positive. We want for the government on a federal and state level to do their damn job and stop bickering and heed our warnings before there is nothing left to bicker over. Worst case scenario for the US puts us at 2.2 million deaths based off current scientific models (notwithstanding those who will indirectly die as hospitals are unable to care for the usual slew of chronic medical conditions). By the end of June, for every available critical care bed, there will be roughly 15 COVID-19 patients in need of one. Make no mistake, this is the greatest challenge the world has seen since WW2. The worst is yet to come."


    Zahid Saeed, M.D.

    March 28


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    The many people who simply don't get the horror and non-selective nature of this disease should consider that never before have doctors and nurses written like the above. Not for SARS, not for MERS, not for Zika, maybe for ebola but that does not spread easily unless one handles blood or corpses. This is something the world has not seen since 1918 and it may be even worse than that pandemic. And Georgia is opening tattoo parlors and hair salons. It's easy to be nonchalant and theoretical when you have no involvement.

    I don't know where the hospital ward image Shane D. posted came from. This below is what an ICU area for a COVID-19 patient really looks like. The patient is prone (belly down), under sedation, intubated, and surrounded by equipment - all you can see are the feet.


    ventilator.jpg


    This is the comment with the photo- from the R.N. who took care of this patient:


    "I normally don’t post anything about my work place and my work. But I think, this time, I have to let the fb world know, ‘the reality of my work’ thru my eyes. This might be a long read, so my apologies 😁


    In a normal ICU setting, if you have this kind of patient ( on crrt, manually proned, vasoactives, antiarrhythmics, paralyzed, flolan,intubated,etc), you normally see 1 or 2 more people, aside from the Respiratory Therapist , who will be your partner through out your entire shift and your saving grace, helping you inside this room.


    But not when you have a Covid-19 pos patient. As you try to save your work family from exposure, you will try to fix everything (including all those annoying beeps) all by yourself. As you stay longer inside the room to try to stabilize your patient, you develop claustrophobia from your mask and shield; you sweat as you succumb to the heat from wearing the gown; you suffer imbalance from the noise and the pressure from the room, you develop headache from wearing the helmet/shield and from dehydration and then you start to get dizzy (and yes this is me here).


    And as you step out of the room , you try to hold back the tears when you receive a call from your pt’s family; sobbing because they can’t come and visit their love ones and at the same time, thanking you endlessly. I have never felt so vulnerable...so scared ...and so sad. Yes, I am scared. Scared for my family that I might end up killing them (by bringing this virus home) ...scared for my work family that I may be exposing them ... and scared for me - that I might die alone (if i get it). I go home after each shift- I end up crying... I cry for my patient and their family...for my family....for my work family. And I cry for me too.( hey, no judgement here haha!)


    Had it not been for my mom’s tears and prayers, I would’ve quit...honestly. So thank you ma! Your prayers have helped me face each shift braveIy- and I don’t even complain about reusing my PPE anymore. I am not trying to earn sympathies. I am not trying to be a hero. All I am saying, WE all play an important part in fighting this war. So please, if you could find a little empathy with in your heart to help us save YOU...save your family....save our family.. .and us— PLEASE STAY HOME.

    And we could use a little prayer too.

    #wewillriseup


    ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

    Sorry to use so much space. I wanted some of the skeptical or hardened people here who seem fine with much more of this to get just a glimpse of what it really is. Keep in mind that the above is from intensive care specialists who have seen it all and never complained. Until now.

    • Official Post

    Documents used to make decisions and the minutes of meetings of the Scientific Advisory Group on Emergencies (SAGE) will only be made public when the current outbreak is brought under control, according to Patrick Vallance, the government’s chief scientific adviser.


    In a letter sent earlier this month to MP Greg Clark, who chairs the House of Commons science and technology committee, Vallance said: “Once SAGE stops convening on this emergency the minutes of relevant SAGE meetings, supporting documents and the names of participants (with their permission) will be published.”


    https://www.newscientist.com/a…shed-until-pandemic-ends/

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