Atlanta hospitals are again open for elective surgery. The way things are going, I fear they will have to close again soon. See:

Current hospital cases by day in Georgia

https://www.ajc.com/news/coron…d/jvoLBozRtBSVSNQDDAuZxH/

Today, I got in under the wire for minor surgery that was put off months ago when the pandemic began. It turned out to be nothing serious, but it did call for full anesthetic etc. It was in a specialized facility with no COVID patients. It was a surreal experience, like something out of a sci-fi movie. The surrealism begins when they make you take a COVID exam no more than 3 days before the treatment. That is problematic because it sometimes takes 2 days to get the results, and test facilities are again jammed up and will soon be overwhelmed with patients, slowing down the turnaround. So, the consequences of not having enough testing may include shutting down elective surgery for unrelated diseases because you cannot get tested. In this case, the hospital has their own facility with quick turnaround. They set up in an abandoned shopping mall department store -- straight of of an end-of-the-world disaster sci. fi. movie! They did the test at 1:48 p.m. Monday and posted the results at 11:50 p.m. the same day.

In today's hospital, there is no waiting allowed in the waiting room. You have to come to the door right on time, and they whisk you into the operating room. Most of the furniture in the waiting room is piled up to prevent waiting. If you are early, you wait outside in the car. If you are late, too bad, they cancel.

They take your temperature of course. You have to wear a mask the whole time. You, the patient. Not just the staff. Good hospitals have always been attentive to cleanliness, but I sense this has been ratcheted up.

No one is allowed to accompany you into the hospital. Someone has to drive you home after the anesthetic, so they make your designated driver wait outside and they call him or her on a cell phone when they finish and you wake up. The driver pulls around and they wheel you out in a wheelchair.

Grocery shopping and much else has been changed by the pandemic, but I think primary education and medical care have changed the most. Some of these changes are beneficial. They should have tightened up cleanliness in hospitals years ago. U.S. hospitals are rife with hospital-borne disease (nosocomial infections). See:

https://www.theatlantic.com/ma…-killed-my-father/307617/

Anyone who imagines that the coronavirus is not a serious disease much worse than the flu -- or that it is not widespread, or that it is fake news -- should spend 10 minutes talking to doctors and nurses at any hospital. Even this hospital, which has no COVID patients. They were depressed. They were astounded and appalled at how badly the U.S. government and healthcare system has botched the response. "Richest country on earth" my ass! Yeah, some of our hospitals are good, but our public health system is little better than a third world hellhole. Especially here in the south, our federal and state governments are not only doing nothing to stop the pandemic, they are actively hurting the efforts. Georgia Governor Nitwit is threatening to sue Savannah and Atlanta because the city mayors want to make face masks mandatory. We can't have common sense measures that were mandatory in 1918! Oh, no. By October ~45,000 more people in the U.S. will die (https://covid19.healthdata.org/united-states-of-america) because masks offend right-wing nutcases who publish cartoons like this one, attacking a Republican governor, for crying out loud, claiming that putting on a mask is like being sent to a concentration camp in a cattle car:

https://www.nytimes.com/2020/0…ly-holocaust-cartoon.html

This is lunacy.

BCG vaccine may be a reason for lower mortality in third world countries

Lower mortality in third world countries is a puzzle.

Dr Richard and others might say this is to be expected as they use HCQ.

Some think it might be a less lethal strain of the virus.

This paper suggests the BCG vaccine may be a part of the answer.

"One sample that stood out was Germany, which had different vaccine plans prior to the country's unification in 1990. While West Germany provided BCG vaccines to infants from 1961 to 1998, East Germany started their BCG vaccinations a decade earlier, but stopped in 1975. This means that older Germans—the population most at risk from COVID-19—in the country's eastern states would have more protection from the current pandemic than their peers in western German states. Recent data shows this to be the case: western German states have experienced mortality rates that are 2.9 times higher than those in eastern Germany."

Brazil is going all in on HCQ

So for those who complain that HCQ investigation has been closed down by politicised parties, who oppose Trump, the good news (maybe) is that politicised parties who support Trump (in this case Bolsonaro) are doing the big experiment with HCQ on the population of Brazil.

Quote from ZenoOfElea

are doing the big experiment with HCQ on the population of Brazil.

Dr Richard would say "Where's the zinc?" Jair

"

Now the far-right populist is putting his convictions to the ultimate test:

Bolsonaro on Tuesday announced that he had tested positive for the disease and was taking hydroxychloroquine.

Bolsonaro said in a televised interview that he had taken an initial two doses, in conjunction with the antibiotic azithromycin, and felt better almost immediately. His only regret, he said, was not using it sooner.

“If I had taken hydroxychloroquine preventively, I would still be working” instead of heading into quarantine, Bolsonaro said.

Later, in a separate video, he gulped down a third pill."

Quote from ZenoOfElea

Lower mortality in third world countries is a puzzle.

I doubt it is a puzzle. From what I know of third world countries, most patients never show up at the hospitals. They die at home, uncounted. In the U.S. that would make mortality look lower. Fewer dead people on the radar improves the stats. But in third world countries only rich people are on the radar. They only count wealthy people who get first-world treatment at fancy hospitals. Their survival rate is much higher than the general population in those countries. It is much higher than the U.S. general population. If you were to tally up the infection rate and survival rate for American millionaires only, ignoring everyone else, our numbers would look fantastic.

There is a huge gap in the coronavirus prognosis in the U.S. between social, economic and racial classes. Poor people are much more likely to get it, and much more likely to die from it. For obvious reasons. The gap is even worse in the third world.

There is a similar large gap between U.S. social classes for many other diseases, childbirth, obesity and so on. Being born in the wrong zip code takes 20 years off your life. That does not happen in other first world countries. I know poor, elderly rural people in Japan who make ~$12,000 a year, yet who live as long as any middle class American.

Quote from Mark U

'm just repeating the widespread terminology out there. What, do you expect cases to go to zero for months, and then rise to heights, before you call it a second wave?

The epidemiologists call second wave the virus coming back (maybe slightly changed) after having been knocked out by summer weather etc.

In texas etc it is just continuation of first wave.

I know it is widespread terminology but unhelpful because it implies we have beaten the first wave through what we did. Not true, we simply delayed it, in some places. Not even that in others.

THH

Quote from ZenoOfElea

BCG vaccine may be a reason for lower mortality in third world countries

Lower mortality in third world countries is a puzzle.

Dr Richard and others might say this is to be expected as they use HCQ.

Some think it might be a less lethal strain of the virus.

This paper suggests the BCG vaccine may be a part of the answer.

"One sample that stood out was Germany, which had different vaccine plans prior to the country's unification in 1990. While West Germany provided BCG vaccines to infants from 1961 to 1998, East Germany started their BCG vaccinations a decade earlier, but stopped in 1975. This means that older Germans—the population most at risk from COVID-19—in the country's eastern states would have more protection from the current pandemic than their peers in western German states. Recent data shows this to be the case: western German states have experienced mortality rates that are 2.9 times higher than those in eastern Germany."

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Or, more likely, a much younger population => much lower mortality!

7 years older => 2 X mortality (roughly)

THH

Senegall and Costa Rica and Algeria

Quote from ZenoOfElea

Lower mortality in third world countries is a puzzle.

Third world is so..oo twentieth century-ist and generalist

I think we need to look at countires case by case.. and even state by state HCQ.. non HCQ... early community intervention drug availlabilty isolation measures age structure housing population density etc etc..

an epidemioogy approach

Senegal Costa Rica Algeria Arizona Hawaii..

of course there are broad statisti -ticks but the devil is in the details..

Even if we see large number of hospital cases, if the usa care is like in sweden then the cases treated at ICU will have very low mortality like 1 out of 20 dies. So if the cases are from young people hence no paleative care, then large hospital cases will not show much in the death statistics. However if, as typically happens, young infect older, death statistics will raise, but with a significant delay. Now getting the bad covid is not good as well and we shouled have som kind of statistics for that as well, like number of lost working days due to the infection.

second wave? for the US I would expect that IF it happens it would be around Dec.

waves seasonality

https://www.contagionlive.com/…ghly-seasonal-study-finds

4 Known Human Coronaviruses Are Highly Seasonal, Study Find

All 4 of those were found to be highly seasonal. ….

“Combined over the 8 years, the number of identifications for each virus increased in December, peaked in January or February, and began to decrease in March,” ….

https://jamanetwork.com/journa…kopen/fullarticle/2767010

Temperature, Humidity, and Latitude Analysis to Estimate Potential Spread and Seasonality of Coronavirus Disease 2019 (COVID-19)

The 8 cities with substantial community spread as of March 10, 2020, were located on a narrow band, roughly on the 30° N to 50° N corridor...

The distribution of the substantial community outbreaks of COVID-19 along restricted latitude, temperature, and humidity measurements were consistent with the behavior of a seasonal respiratory virus. The association between temperature and humidity in the cities affected by COVID-19 deserves special attention. There is a similarity in the measures of mean temperature (ie, 5-11 °C) and RH (ie, 44%-84%) in the affected cities and known laboratory conditions that are conducive to coronavirus survival (4 °C and 20%-80% RH)

Quote from stefan

Even if we see large number of hospital cases, if the usa care is like in sweden then the cases treated at ICU will have very low mortality like 1 out of 20 dies.

Countries should avoid doing anything that Sweden does.

Sweden is the worst hit first world country. Sweden's mortality rate per capita is 40% higher than the U.S. It is the only first-world country much worse off than the U.S. It has also had as much damage to the economy as the other Scandinavian countries.

See:

https://www.nytimes.com/2020/0…-economy-coronavirus.html

Sweden Has Become the World’s Cautionary Tale

Its decision to carry on in the face of the pandemic has yielded a surge of deaths without sparing its economy from damage — a red flag as the United States and Britain move to lift lockdowns.

LONDON — Ever since the coronavirus emerged in Europe, Sweden has captured international attention by conducting an unorthodox, open-air experiment. It has allowed the world to examine what happens in a pandemic when a government allows life to carry on largely unhindered.

This is what has happened: Not only have thousands more people died than in neighboring countries that imposed lockdowns, but Sweden’s economy has fared little better.

“They literally gained nothing,” said Jacob F. Kirkegaard, a senior fellow at the Peterson Institute for International Economics in Washington. “It’s a self-inflicted wound, and they have no economic gains.” . . .

. . . Sweden’s grim result — more death, and nearly equal economic damage — suggests that the supposed choice between lives and paychecks is a false one: A failure to impose social distancing can cost lives and jobs at the same time.

Sweden put stock in the sensibility of its people as it largely avoided imposing government prohibitions. The government allowed restaurants, gyms, shops, playgrounds and most schools to remain open. By contrast, Denmark and Norway opted for strict quarantines, banning large groups and locking down shops and restaurants.

More than three months later, the coronavirus is blamed for 5,420 deaths in Sweden, according to the World Health Organization. That might not sound especially horrendous compared with the more than 129,000 Americans who have died. But Sweden is a country of only 10 million people. Per million people, Sweden has suffered 40 percent more deaths than the United States, 12 times more than Norway, seven times more than Finland and six times more than Denmark.

‘DEPART from evil, and do good; seek peace, and pursue it’ – Psalm 34:13

Zev Zelenko ,,, in serious Hasidic iconoclastic mode

.. facebook youtube google...NEJM JAMA Lancet peer review..

WHO - World Homicidal Organisation

Maseltov! on https://crowdprotocol.com/

https://conservativewoman.co.u…-with-hydroxychloroquine/

Aryeh Katzin is a Rabbi from Brooklyn of Russian background who opposed the Soviets.

Dr Edmund Fordham is a physicist and engineer, recently retired from his role as Scientific Advisor to a leading international company in the petroleum industry.

He is an expert in applications of Nuclear Magnetic Resonance to oil-bearing rocks.

He took a First in Physics at Cambridge, wrote his doctoral thesis on wind energy, working with Nobel Laureate Sir Martin Ryle, and has also worked on nuclear reactor safety.

I have recorded the transcript for the sake of posterity..

My attention has just recently been drawn to this interesting document. (I searched for 'master question' here ... sorry if it's a duplicate)

Dept of Homeland Security (DHS) SCIENCE AND TECHNOLOGY

Master Question List for COVID-19 (caused by SARS-CoV-2)

Main page : https://www.dhs.gov/publicatio…er-question-list-covid-19

The Department of Homeland Security (DHS) Science and Technology Directorate (S&T) developed the following “master question list” that quickly summarizes what is known, what additional information is needed, and who may be working to address such fundamental questions as, “What is the infectious dose?” and “How long does the virus persist in the environment?” The Master Question List (MQL) is intended to quickly present the current state of available information to government decision makers in the operational response to COVID-19 and allow structured and scientifically guided discussions across the federal government without burdening them with the need to review scientific reports, and to prevent duplication of efforts by highlighting and coordinating research.

Current weekly report (changes from last week are in blue)
https://www.dhs.gov/sites/defa…blic_release_20200707.pdf

Quote from JedRothwell

Countries should avoid doing anything that Sweden does.

Sweden is the worst hit first world country. Sweden's mortality rate per capita is 40% higher than the U.S. It is the only first-world country much worse off than the U.S. It has also had as much damage to the economy as the other Scandinavian countries.

See:

https://www.nytimes.com/2020/0…-economy-coronavirus.html

Sweden Has Become the World’s Cautionary Tale

Its decision to carry on in the face of the pandemic has yielded a surge of deaths without sparing its economy from damage — a red flag as the United States and Britain move to lift lockdowns.

LONDON — Ever since the coronavirus emerged in Europe, Sweden has captured international attention by conducting an unorthodox, open-air experiment. It has allowed the world to examine what happens in a pandemic when a government allows life to carry on largely unhindered.

This is what has happened: Not only have thousands more people died than in neighboring countries that imposed lockdowns, but Sweden’s economy has fared little better.

“They literally gained nothing,” said Jacob F. Kirkegaard, a senior fellow at the Peterson Institute for International Economics in Washington. “It’s a self-inflicted wound, and they have no economic gains.” . . .

. . . Sweden’s grim result — more death, and nearly equal economic damage — suggests that the supposed choice between lives and paychecks is a false one: A failure to impose social distancing can cost lives and jobs at the same time.

Sweden put stock in the sensibility of its people as it largely avoided imposing government prohibitions. The government allowed restaurants, gyms, shops, playgrounds and most schools to remain open. By contrast, Denmark and Norway opted for strict quarantines, banning large groups and locking down shops and restaurants.

More than three months later, the coronavirus is blamed for 5,420 deaths in Sweden, according to the World Health Organization. That might not sound especially horrendous compared with the more than 129,000 Americans who have died. But Sweden is a country of only 10 million people. Per million people, Sweden has suffered 40 percent more deaths than the United States, 12 times more than Norway, seven times more than Finland and six times more than Denmark.

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I did not imply that sweden has got a nice case. Just that our medical stuff learned a lot how to treat corona patients (for which we got a huge bunch of) and that since may it has possibly been mainly paleative care that results in deaths, So I assumed the similar has happened in US. The statistics ins not finished but it is telling that the deaths goes from 1/3 in march to 1/20 in may.

We might have a change of the type of patients that goes to the icu so it is not clear yet it's all due to good medical development.

By I do not like your wording that sweden did not do well. It's actually twofold, actually, the outcome all depends on the amount of spread when the authorities notice it (that's why it is so crazy to open up with too much spread in the country), Week 9 was crucial as 1/10th of the population was traveling abroad around our winter break and we got a lot of spread into the country and then a big event of 15000 people made the start population of infected in the beginning of the spread quite large and as you understand exponentials preserves fractions e.g. start with 2x amount, you end up with 2x amount. I know that danish people has 5x less travel intensity than Sweden, Norway and Finland has not similar dense regions as Sweden and Denmark, Noway, Denmark and Finland had their winter break week 8 when there was less spread. In all that explains why Sweden started off with maybe 5x more infected then Denmark and you see that the end result compare, so we did the same as Denmark did, but with 5x worse outcome just out of the society differences. So the actual strategy was not much worse then Denmarks. The mistake was not to close down the air travelling early and also the big event should never have happened as we knew at that time there was a community spread in the country. As it looks countries with busy airports in Europe results in 400-600 deaths per million, you would not go down in resolution as there is just to much unknonwns to understand if the one having 400 did better than the one having 600, that's the result of rolling dices. Germany is a big questionmark, but I think that they did not include elderly care numbers in the statistics (I might be wrong). Anyway community spread means that it is not possible to track with current methods and that was what all those countries ended up with. I fear that we do not learn what really caused this problem and will fair much worse when the next super virus comes around, like an ebola with the same R0 as covid. We simple must learn to close the boarders and monitor the traffic in and out of our countries and have a red big stop button for our travel.

Me and 95% of the Swedes does not see a difference between how we sheltered and e.g. danish people sheltered. Sure more things where open like restaurants, but we did not go there, hence one clue of the bad economic outcome, we did have open schools, but teachers was due to statistics not infected much so that was not a problem and an economic boon although you do not see it in the BNP. We also export a lot and suddenly due to the close down there where no customers, so although we could produce, we could not due to other countries lock down. The toilet paper industry flourished though ;-). You sometimes see pictures of crowded places in international news from early on, but that cherry picking. 99% of Sweden was void of people basically nobody was consuming anything.

finally Sweden is not worst, saying that USA has only 400 deaths per million is a bit of cherry picking as USA is big and the result is a mean of a lot of different random outcomes. So you should compare with different states, but even this is difficult. But then the picture changes and Sweden regarding statistics.

Quote from JedRothwell

Sweden is the worst hit first world country. Sweden's mortality rate per capita is 40% higher than the U.S. It is the only first-world country much worse off than the U.S. It has also had as much damage to the economy as the other Scandinavian countries.

Sweden did see a more or less linear decreases in cases/deaths. Pleas keep in mind that the true answer only will shine up later when Sweden shows the excess mortality. At least 50% of the older deaths would have died anyways the next 6 months. The US statistics linked above shows some clear trends to absolute lowest excess mortality especially among the "middle age" groups.

How many deaths will you accept for starting again a normal live?

Just to remind you that every day about 20 US citizens die due to slippery soap in the shower/bath! About 50 in car accidents - may be currently less. 40 in shootings...

This below ended up in the wrong thread... Even after moving...

Some news from the anti body side (Regeneron) . Phase 3! Hopefully no side effects.

https://newsroom.regeneron.com/node/24026/pdf

The source site of the news:

https://www.coronavirustoday.com/covid-19-treatments

Quote from stefan

I did not imply that sweden has got a nice case. Just that our medical stuff learned a lot how to treat corona patients (for which we got a huge bunch of) and that since may it has possibly been mainly paleative care that results in deaths, So I assumed the similar has happened in US.

You make a good point. And the doctors in Sweden are getting lots of practice! They have more patients and more deaths than any other group of doctors in the world.

Quote from Shane D.

Doctors do communicate, and learn from one another.

They sure do. As I mentioned, I was in for surgery yesterday. (It was benign, thank goodness.) It was delayed somewhat, so I was gabbing with the doctors, surgeon, anesthesiologist and nurses, and listening to their gossip. I asked what they thought of the coronavirus. As I said, they were horrified. All of them were aghast at the disaster here in Atlanta and at the national level. They said "I never imagined such a thing could happen in the U.S." Anyway, they knew a terrific amount about it on the clinical level, and therapeutic level. As far as I know, they have not been assigned to those wards themselves. The nurse says she hasn't been. But of course they have heard all about it from their colleagues and they know a lot.

The other day, 1,400 Georgia doctors and nurses signed a petition asking Gov. Nitwit to do something to slow down the epidemic. Naturally, he ignored them. He didn't even respond as far as I know. It is like taking to a brick wall! Trump, VP Pence, Gov. Nitwit and the other leaders apparently don't give a damn how many people die, and how many young people are disabled for life with strokes and amputations. They will not spend a dollar on case tracking. They will not lift a finger to stop the carnage. Their only concerns are getting re-elected and getting the Dow Jones Industrial Average back up.

https://www.cnn.com/2020/07/04…virus-petition/index.html

In another few weeks the hospitals here will probably again be overwhelmed, and surgery will again be postponed. We are not talking minor surgery. I got in just under the wire, with something that might have been very serious. As in, fatal. (But it wasn't.) A lot of people will have surgery postponed until the cancer or heart problems or whatever it is kills them. They will also be victims of Trump, Pence and Gov. Nitwit.

Quote from JedRothwell

You make a good point. And the doctors in Sweden are getting lots of practice! They have more patients and more deaths than any other group of doctors in the world.

yes one may think that Sweden is tiny, But over the world the hospitals has about similar uptake regions and the icu's have been very busy, especially in Stockholm. Amazing that they had the time to analyze and develop treatment as well and not only fix the most urging issues. I suspect many late nights have been spent thinking about improvements. It's actually amazing how the whole medical research world have the focus on covid 19. I think that the medical knowledge development is outstanding. Also with internet, I assume that there is a high level of sharing of information all over the world so it's essentially hard to attribute improvements to a specific country when one is not an expert. I wait for more information regarding these stats and will report if something new turns up.