I posted this in the New Forum Topics and thought it could be useful info here too.
I am a physician and so when Labcorp started running tests yesterday and Quest will be running them as of Monday, I thought I should get some kits so I can do some testing if the question comes up.
However, the devil is in the details. First of all, we don’t have PPE at my practice. This requires PPE. Second, the CDC kits (I would not be using those anyways) require keeping them in a refrigerator and then transporting them on ice. Don’t have either of those at my office. Thankfully it seems Labcorp and Quest will use regular viral transport media.
Labcorp says they want a nasopharyngeal swab. The test most of us are familiar with is the pharyngeal swab for strep throat. I have never done a nasopharyngeal swab. I have some idea how to do it, but even suppose I could set up a drive through in my office parking lot, with my one N95 mask from the NorCal fires and suited up somehow with goggles, and hair covering, I am not so sure I would do a good job and there would be a raised chance of a false negative.
Finally, results on the LabCorp test would take 2-3 days.
So… it was meaningless when Pence said that doctors could do their own tests, that we will have a million available and other empty promises. There is endless liability if you want to be enterprising and set up drive-through testing – how will you protect your employees? They will have to be taught how to do the test correctly (one of the youtube videos shows just how deep they go with that swab and vigorously swab in there to make sure they got it), and provided with suitable protection.
I sure hope the hospitals are working on it because I can’t do it on my own as an independent physician.
A friend says the infectious disease department at the hospital she works at (SoCal) limits tests to only patients who are in critical condition. I bet that is why, though that puts all health care workers at risk as they admit other patients with cough and fever who are not (yet) critically ill. I continue to be in awe of countries that have done so much more testing than we have
Firstly -
“To use a different name just because Chris doesn’t like what WHO is doing just seems petty.“
Oh please, the WHO - the organization that won’t declare a “Pandemic” ahh and why is that? That’s petty, or is it a crime against humanity because it would effect “Pandemic Bonds”?
How insulting of you to suggest Chris is petty!!! Maybe, like a lot of us he is pissed. And I love the name Honey Badger! Chris will go down in history as providing more verifiable and intelligent information on this Pandemic than anyone else. Perhaps there could be something else for you to focus on, your complaint seems petty!!!
Secondly, Sparky1 you are an asset to PP and a delight to read. I understand your frustrations and think your suggestions are valuable. I suspect that behind the scenes people know the limitations and shortcomings of the website and are working hard on them.
As our country and the globe slides into disruptions and chaos the sites limitations may seem trivial and irrelevant in comparisons to global problems?
Who cared if the radio didn’t work or the towel dispenser was empty as the Titanic filled with water? Did it matter in the long run?
Perhaps I am just more syndical than you. Hope I am wrong.
From my limited perusing of the HTML for pages here, the site is using wordpress for posting. They would need a wordpress developer to help with tweaking and fixing issue with the site.
This is a time to take those down temporarily. Journals have taken them down so we can all ready the emerging science on COVID-19. I am stuck getting my news from local TV channels because I can’t be subscribing to all of them - SF Chronicle, LA Times, Seattle Times, Bloomberg, NYT, WSJ, and so many more. All this journalistic work going to waste and everyone telling me they are not concerned! (because they are not informed!)
I’m writing these news outlets requesting this, and would encourage you all to do the same. Paywalls are elitist. We must find another way to fund news. With Chris saying we need to cut our budget, how do we choose which ones to subscribe to?
I think i got the virus. I was very short of breath and a dry cough. Also i felt some minor pains in my eyes.
I have been high on vitamine D for months thanks to the discover of a tumor in my colon which was removed autumn last year.
The day before yesterday i started to feel real bad. Yesterday i took every 2 hours 1000 milligrams of time released vitamine C. 8 of them. Today i am feeling much better, breathing is much better. I have still a bit cloudy brain but that is not to bad. Today i will take 4 of those vitamine C.
Definitely you should take vitamine D daily and when you start feeling sick hit it with vitamine C.
For recommendations see
http://orthomolecular.org/resources/omns/v16n06.shtml
So taking vitamine C preventive is maybe also not a bad idea.
“While in hospital, Miss N, her brother and sister-in-law took turns to visit and take care of her mother. They were wearing very simple protection: gloves and masks. Also noted is that while her mother got sick at home, none of the five other family members was wearing any mask for several days. But all of them went on oral vitamin C tablets. None of them developed COVID-19 infection.”
http://www.orthomolecular.org/resources/omns/v16n17.shtml
CJRinMN, thank you for posting the link to the families’ press conference. I’m reposting your comment with link here. Here’s the direct link to today’s press conference by families of the Washington nursing home resident, here.
This is a clusterf**k if there ever was one. The daughter of a asymptomatic, undiagnosed woman was notified that her mother had passed at 3:30 a.m., only to be notified by her designated facility contact seven hours later that her mother was fine. (She was, in fact, dead.) This daughter raises a good question about whether her now deceased mother will be tested for the coronavirus. How many people will die without a proper diagnosis of coronavirus? Testing for the living and the dead is insufficient.
The families of residents cannot get answers or action from anyone, from the nursing home right up to the CDC. It is also very likely that these family members have been exposed and may fall ill with Covid-2019 themselves, many of whom are older adults and therefore at higher risk.
This heartbreak is coming, if not already present, to our local communities. 
COVID19 is confirmed here in Indiana now. cough, cough, sniff, sniff…
Sounds like they had a good plan ready to go for dealing with this.
https://www.wthr.com/article/first-confirmed-coronavirus-case-indiana
The Indiana State Department of Health (ISDH) announced Friday the first case of coronavirus in the state. The person was identified as an adult from Marion County who had traveled to Boston recently and had been at an event where other people have also tested positive. They returned to Indiana on Wednesday, March 4. The patient and Community Hospital North took precautions to keep this case from spreading. ISDH is working closely with the Marion County Public Health Department, Community Hospital North and the Centers for Disease Control and Prevention to ensure that any close contacts of the patient are identified and monitored, and that all infection control protocols are being followed. A Community North spokesperson said the infected person called the state health department last night. They were asked to go to Community North Hospital. Once there, hospital workers met the person in the parking lot while wearing infectious disease protective gear. The infected person was brought in an entrance where no one from the public was present and was examined in a special room designed to handle an infectious disease case like COVID-19. ... According to ISDH, human coronaviruses most commonly spread from an infected person to others through:
- Respiratory droplets released into the air by coughing and sneezing
- Close personal contact, such as touching or shaking hands
- Touching an object or surface with the virus on it, then touching your mouth, nose, or eyes before washing your hands
- Rarely, fecal contamination.
Sofistek
Youtube has software listening for use of key terms (COVID19, coronavirus, etc) being used by unofficial (or non-MSM) channels and will adjust their search and recommendation algorithms to suppress/bury those channels.
Perhaps they are also auto-unsubscribing recently added users as well, something Chris has highlighted in a video or two recently.
https://www.wthr.com/article/siriusxm-launches-free-coronavirus-information-channel-help-line
SiriusXM will launch a special 24/7 channel dedicated to providing the latest information on the coronavirus outbreak. The channel, according to a media release from SiriusXM, will feature New York University Langone Health's team of world-class infectious disease and medical authorities, and will launch Friday, March 6 at 6 p.m. ET. Subscribers and nonsubscribers alike will be able to listen on both active and inactive SiriusXM radios at Channel 121. The channel will also be available on the SiriusXM app and SiriusXM.com. As the public service, the channel will feature nonstop information and health tips related to coronavirus.
In case you find yourself trying to close a school against an administrator who claims that children have not been found to be significant in the transmission, here is a recent article that raises the concern that indeed they are significant:
Epidemiology and Transmission of COVID-19 in Shenzhen China: Analysis of 391 cases and 1,286 of their close contacts:
https://www.medrxiv.org/content/10.1101/2020.03.03.20028423v1
It is very hard for me to envision where all of this viral infection leads to and what the general fallout to society will be.
But here is one commentator’s summary:
What we have here, folks, is destruction by definition.
Supply chain disruptions breed consumer good disruptions, which breed declining sales, which breed disappearing cash flow, which breed layoffs, which breed less Ford F-150 sales, which breed shrinking tax receipts, which breed unserviceable public and private debt, which breed mass bankruptcies, which breed game over.
Maybe there are no more cases in hubei because everyone is either already sick, or dead.
Lack of paid sick leave puts workers, public at risk in coronavirus outbreak
https://www.msn.com/en-us/news/us/lack-of-paid-sick-leave-puts-workers-public-at-risk-in-coronavirus-outbreak/sl-BB10O2PQ?ocid=spartandhp
Gosh Sandpuppy, you read all those dystopian novels, I was counting on you to provide a post with detailed insights. Darn, guess my anxious imagination will will conjure fodder for my 3:00 am angst.
The conclusion of the 9-11 commission was - - Failure of Imagination”hah rather I think they got an A for imagination. However, now they may not have anticipated the longterm consequences of their actions. If you get my unspoken message.
Gloomy Granny
Silver has the antiviral and antibacterial qualities, no?
I bought a pillow case with silver infused cloth, which I can cut up and use for a non-disposable mask. I saw a video this morning, with S Korean ladies sewing cloth masks for the poor, which have a pocket for replaceable fliter materials. I’ve got the copper and zinc sulfates in which to dip my filter layers. And after a day’s wear, pop them out, wash the outer mask, and we’re good to go!
Not perfect, but a damn sight better than nothing.
Link to video: https://youtu.be/VN1DfpALj5Y
First U.S. Colleges Close Classrooms as Virus Spreads. More Could Follow.
https://www.msn.com/en-us/news/us/first-us-colleges-close-classrooms-as-virus-spreads-more-could-follow/ar-BB10QkYI?ocid=spartanntp
Chris has long since ceased to be a balanced and evidence based investigator.
CFR
Nearly all the statistics we have access to are likely significantly overestimating the CFR because:
(1) Medical systems simply don’t see, and therefore don’t count, many cases which develop only mild symptoms.
(2) Tests appear to have a high rate of false negative results.
(3) In many areas testing capability remains severely limited. Countries which do more testing (e.g. South Korea 2100 per million) see lower fatality rates than countries which do less (e.g. Italy 380 per million) presumably because they test more people without, or with merely mild, symptoms and therefore under-report cases to a lesser degree.
(4) The average time to recovery is significantly longer than the average time to death which skews the ratio heavily towards death in the early stages of any specific outbreak.
The best case study we have is the Diamond Princess because everyone was tested - so most cases including the completely asymptomatic ones would have been caught with only false negatives escaping detection. 3760 people were on board skewed heavily towards an older demographic. The demographic should mean that the CFR is considerably worse on board this ship than in the general population. Even in this heavily skewed demographic about 50% of the ~700 cases were completely asymptomatic and there have been a total of 6 fatalities for a CFR of ~0.85%. If we assume some false negatives escaped detection this might drop to 0.75% of passengers whose average age might easily have been 60 (average age of cruise ship passengers 47 + Princess Cruises markets to older demographic + outside school holidays / summer season + non-Caribbean cruise all skew average age higher). Not one single death among passengers has been in a person under 70.
My guess is that the CFR for people under 50 (currently estimated at 0.2% per statistics subject to the flaws I identified above) will turn out to be a lot lower than 0.1%.
R0
There are a host of studies on the R0 number. Most are extremely error prone as they are based on highly questionable data and highly questionable assumptions. Chris focuses only on those reports which conclude the highest possible value of R0.
My guess is that this is signifcantly below 3.0 and with sufficient intervention can clearly be dropped to below 1 as it likely has been in China. Since the CFR is so low, we probably do not need that level of intervention. We merely need to keep the R0 low enough (<2) that we don’t overwhelm our hospital systems. This should not be too difficulat to achieve.
Aerosol spread
While this has been reported, it is not at all clear to what degree and how frequently it happens.
Economic Impact
China likely over-reacted to the disease and their economy has clearly been impacted. That will have a knock on effect. However I think that this whole thing will largely blow over in a few weeks and any impact will quickly recede into memory.
I am a buyer of Chinese airlines, travel agencies, hotel chains etc. The bargains available are astonishing. I’m not sure I have enough balls to buy crusie lines though - which probably means they’re even better deals :-).
I could use a little tax relief and/or helicopter money as well. I promise to spend it to help the economy. Where is the relief for the average consumer who will bear the brunt of this financially and physically if sick (or dead)?
White House considers tax relief for airlines, travel firms amid coronavirus
https://www.reuters.com/article/us-health-coronavirus-usa-stimulus/white-house-considers-tax-relief-for-airlines-travel-firms-amid-coronavirus-idUSKBN20T226
I wouldnt count on that - though it does have some antigermicidal properties, It would need contact far to long to be effective for a respirator. ( you need something less than 1 micron to really filter this out. most n95 wont do that. but it could possibly, give you enough protection in low concentrations of virus ( meaning in a store away from people ) to provide protection for short periods. It will not do much if you are in a drs office and people are hacking.