Short-term US outlook for Covid-19

WARNING: THIS IS ABOUT PROBABLE OUTCOMES FOR THE CORONAVIRUS EPIDEMIC AND ANYONE WHO IS ALREADY ESPECIALLY STRESSED MAY WANT TO SKIP THIS ESSAY.

Although there is not much that can change outcomes for people who are already infected with the coronavirus, a community effort to slow the spread of the disease can make a big difference. Isolating ourselves as much as possible, wearing cloth or paper masks when it is essential to leave home, and washing our hands properly can make a real difference.

I have great sympathy for the protesters in Ohio, but the epidemic really is serious. A partial quarantine causes the economic problems we are seeing but will not stop the epidemic. Trying to restart the economy without getting control of the epidemic will not work. About 20% of the people with confirmed cases became seriously ill. If a large proportion of the population is ill or caring for the sick the economy will not be able to restart anyway.

The government statements about the seriousness of this epidemic keep changing, but they seem to have accepted that we will lose 100,000 to 250,000 citizens. This is probably optimistic.

Johns Hopkins has a website that gives raw numbers on the progress of the Covid-19 epidemic. It provides daily updates. At 6:32 am EDT on April 14 they reported about 25,000 new cases in the last day and a total of about 550,000 confirmed cases in the US. They also reported 21,662 confirmed deaths and reported 32,998 people to be recovered. These numbers are based on the availability of testing. Some of the numbers are probably based on the people who were ill enough to have chest X-rays. They are certainly an underestimate of the actual cases, but do give some idea of the situation.

https://coronavirus.jhu.edu/data/mortality

The team at Johns Hopkins noted that:

Differences in mortality numbers can be caused by:

Differences in the number of people tested: With more testing, more people with milder cases are identified. This lowers the case-fatality ratio.
Demographics: For example, mortality tends to be higher in older populations.
Characteristics of the healthcare system: For example, mortality may rise as hospitals become overwhelmed and have fewer resources.
Other factors, many of which remain unknown.

Elsewhere it has been reported that New York City does not count people as Covid-19 cases if they do not arrive at the hospital alive. There is a reasonable reluctance to waste limited testing resources on people who can no longer receive medical help and who will not pose a risk to staff or other patients. Other Covid-19 victims, including people in nursing homes, may not be included if they were not tested. There does not seem to be a significant effort to trace contacts of people who have been infected.

covid 4.14 linear confirmed.png
https://coronavirus.jhu.edu/data/mortality

The case fatality rate is reported to be 4.1% in the US. The actual fatality rate is probably about 1% but people with mild cases are not nearly as likely to be tested as long as there is a shortage of testing supplies. About 80% of the people with symptoms will just have mild symptoms or feel like they have a bad cold. Quite a few people do not even have noticeable symptoms.

There are more than 500,000 people who currently have confirmed cases of Covid-19. Assuming a 4% mortality rate we can expect to lose about 20,000 of them.

On the average each infected person probably passes the virus on to 2-3 other people. This means that the 500,000 people known to be infected with Covid-19 have probably passed the virus on to about 1,000,000 others. This is likely to cause 40,000 more deaths.

21,662 confirmed deaths
20,000 probable deaths due to confirmed cases
40,000 probable deaths due to currently asymptomatic infections
_______
80,000 probable deaths

Even if warmer weather and the Easter miracle predicted by President Trump completely stopped any further transmission of the virus we could still expect to see 80,000 deaths. Seasonal flu generally causes 25,000 to 60,000 fatalities.

I sincerely hope their estimates of 100,000 to 250,000 fatalities is correct but do not have much confidence in their competence.

********************
This is a revised version of my coffee-filter mask essay from a couple of weeks ago:
Everyone who cooks, delivers or hands food out through a takeout window should be wearing a mask. All store clerks should be wearing masks both for their protection and the protection of the customers. Everyone going to a pharmacy or to get medical care should certainly be wearing a mask. Since there are not enough surgical masks and other protective equipment for medical personnel the rest of us need to improvise. Fabric masks and other types of masks can at least decrease exposure to airborne droplets containing infectious viruses. These are directions for mask made of coffee filters. They are not nearly as good as a surgical mask, but are better than nothing.

mask materials.jpg

COFFEE-FILTER FACE MASK

What you need:

Two coffee filters
Two to three feet of craft ribbon or string
Tape

Keep the coffee filters nested. Place them with the cup side down.

Fold the bottom edges of the mask up about an inch (approximately 2-3 cm). Fold the top edge about a half inch (or about 1 cm).

Then fold the top over another half inch. This will make the top part of the mask slightly stiffer so it will hold the bend over your nose better.

Place the ribbon in the top and bottom troughs formed by the folded edges of the coffee filters. Tape the folded edges of the filters down to hold the ribbon in place.

mask folds.jpg

Loop the ribbon over one ear and tie the free ends of the ribbon over the other ear to hold the mask in place over your face. Use a vertical piece of tape on the mask over each cheek to fit the mask to your face once you have put it on.

finished mask.jpg

This mask will not stop lone viruses from getting through because the coffee filter is too porous. It will tend to block large droplets from coughing or sneezing. Droplets can contain huge numbers of viruses and be very infectious.

This mask is not nearly as good as a surgical mask, but better than nothing. It is much easier to wear a mask like this than to walk around holding a tissue in front of your face.

I found that I am sensitive to the odor of cheap masking tape but the cellophane tape was OK for me. Masks should be tested at home for comfort and allergens before trying to use them.

The coffee filters should be thrown away after the mask in used. Washing hands with soap and warm water will destroy the virus, so it is important to wash your hands after handling used masks. The roll of ribbon was 47 cents so this is not too expensive, but I plan on removing the ribbons and washing them in hot, soapy water to use again.

These coffee filter masks are easy to make, fit fairly comfortably and do not require sewing skills. Paper towels could probably be used to make masks but I do not use paper towels and am not about to brave the stores to wrestle other customers for the last roll. This virus can be destroyed by soap and water, acid and/or heat. It generally only survives a day or two on paper. If you cannot get enough coffee filters, leaving the mask in a hot car for a day should kill this virus. The hot-car treatment would not necessarily kill other germs that might be on the mask though.

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Lookout's picture

about the number of asymptomatic COVID infections. (50% - 80%)

Perhaps many more people have already had COVID than has been thought...

What is concerning is the cases of re-infection after getting over COVID...

Difficult to say how this all unwinds.

BTW - what science do you teach? Retired Earth science teacher here.

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“Until justice rolls down like water and righteousness like a mighty stream.”

magiamma's picture

@Lookout
How a stockpile of 39 million masks was exposed as fake

https://www.latimes.com/california/story/2020-04-11/coronavirus-seiu-mas...

A powerful California union that claimed to have discovered 39 million masks for healthcare workers fighting the novel coronavirus was duped in an elaborate scam uncovered by FBI investigators, the U.S. attorney’s office said Friday.

U.S. Atty. Scott Brady of the Western District of Pennsylvania said FBI agents and prosecutors stumbled onto the arrangement while looking into whether they could intercept the masks for the Federal Emergency Management Agency under the Defense Production Act.
The federal government has been quietly seizing supplies across the country, taking the orders placed by hospitals and clinics and not publicly reporting where the products are being routed.

But in this case, there was no warehouse, and there were no masks to seize.

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@Lookout @Lookout Asymptomatic just means that they do not have symptoms at the time they are tested. They often get sick later. Usually people are infected 5-7 days before they show symptoms but they are usually able to spread the virus before the symptoms show up unless they are isolated. I may have found the papers John Campbell is referring to. One is about an outbreak in a nursing care facility in Washington

Two residents of the facility were transferred to a hospital with Covid-19 symptoms. 76 other residents were tested even though they did not have symptoms at that time and 23 had positive test results.

Among the 23 residents with positive test results, 10 (43.5%) were symptomatic, and 13 (56.5%) were asymptomatic. Eight symptomatic residents had typical COVID-19 symptoms, and two had only atypical symptoms; the most common atypical symptoms reported were malaise (four residents) and nausea (three). Thirteen (24.5%) residents who had negative test results also reported typical and atypical COVID-19 symptoms during the 14 days preceding testing.

One week after testing, the 13 residents who had positive test results and were asymptomatic on the date of testing were reassessed; 10 had developed symptoms and were recategorized as pre-symptomatic at the time of testing (Table 2). The most common signs and symptoms that developed were fever (eight residents), malaise (six), and cough (five). The mean interval from testing to symptom onset in the presymptomatic residents was 3 days. Three residents with positive test results remained asymptomatic

Kimball et.al. Morbidity and Mortality Weekly Report 378MMWR/April 3, 2020/Vol. 69/No. 13

There have been reports from China of patients testing positive for the virus after they have recovered in addition to some people who are infected without ever showing symptoms.

Sergio Romagnani, a professor of clinical immunology at the University of Florence, has reported how blanket testing in a completely isolated village of roughly 3000 people in northern Italy saw the number of people with covid-19 symptoms fall by over 90% within 10 days. Vo’Euganeo, 50 km west of Venice, was closed off by authorities in mid-February, at which point repeat RNA testing of the entire population began. All those with positive tests were quarantined. The number of people sick from covid-19 fell from 88 to seven in less than 10 days, Romagnani reported.

Michael Day BMJ 2020;368:m1165 doi: 10.1136/bmj.m1165 (Published 23 March 2020)

We are supposed to stay locked down because we have no idea who is infected if they are not showing symptoms. One paper on the Chinese epidemic estimated that about 5% of the population was infected but did not ever have symptoms. Other papers give different numbers. This is the most difficult part of the situation to estimate although all the other numbers are also imprecise.

A scientific study, rolled out by the University of Padua, with the help of the Veneto Region and the Red Cross, consisted of testing all 3,300 inhabitants of the town, including asymptomatic people. The goal was to study the natural history of the virus, the transmission dynamics and the categories at risk. . . .

“We were able to contain the outbreak here, because we identified and eliminated the ‘submerged’ infections and isolated them,” Andrea Crisanti, an infections expert at Imperial College London, who took part in the Vò project, told the Financial Times. “That is what makes the difference.”

The research allowed for the identification of at least six asymptomatic people who tested positive for Covid-19. ‘‘If these people had not been discovered,” said the researchers, they would probably have unknowingly infected other inhabitants.

https://www.theguardian.com/world/2020/mar/18/scientists-say-mass-tests-...

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Roy Blakeley's picture

@ScienceTeacher as the Italian village data reveals. It is still a key to getting back to normal. The Trump administration and the CDC blew testing big time. Ample tests would have allowed the initial outbreaks to be contained. Tests are still not available. Juan Gonzales on DemocracyNow this morning related his own experiences with his mother and wife in New York City. He had to put forth a lot of effort to get his mother tested (she tested positive) and he still has not been able to get his wife tested (she has symptoms). This all amounts to negligent homicide.

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It would seem that math works against us in this. It's hard to tell what people like Governor Cuomo mean by flattening the curve. The most important measure is the total number of active infections. That determines the hospital load and the probability of infection spread. Right now we are seeing the measure of new infections flatten, but the total active infections are barely changing, still increasing aggressively with perhaps a slight turn to the right. Math is the problem here. At the point that we started social distancing we put a process in place to reduce new infections. It took about three weeks to see the new infections decrease, about April 4. After that new infections started to increase, that's the math at work. The problem in a nutshell is this - The total number of active cases is aggressively increasing. The number of active new cases is a function of the product of R0 (pronounced R-naught), the infection rate, and the number of people infected. The total currently infected keeps rising. In fact it has continued to rise with only a slight hint of letting up. Reducing R0 through social distancing has its strongest effect at the point that it was applied. As time goes on, the increase in total infected increases the number new infections since it's a function of R0 times the current number of infections. The other problem is that the rate of clearing out infections is very slow, so we are adding new infections without clearing out a significant number of old infections, either through recovery or death. That's true in part because of the nature of the disease and the fact that the oldest infections are clearing out first, and that number was very small.

Notice that some politicians are claiming that we have turned the corner. Take a good look at the current graphs for total active infections and deaths.

What will probably happen is that the rate of new infections will stabilize at some point and the total number of infections will then continue to rise linearly. The number of deaths will also follow this pattern.

First- If we want to really "bend the curve" we will need a much smaller R0, more rigid isolation, quarantine, case tracking, and perhaps social tracking, emulating China.

Second- If we back off at all in social distancing then R0 will increase and we are really screwed. I'm just waiting for the first Country/State to try this. Again, the math will hide the real cost of this stupid move, until it is obvious that we are screwed royally.

Third- this shows why early action is critical. You need to keep to keep the total number of infected cases as low as possible, before you get to the steep part of the infection curve, too late for us.

Fourth - The parameter to measure success is the total number of active infections.

Fifth- Our goal should be to decrease R0 to the point that the total number of active cases is flat, and then past that to where they are decreasing with time. Anything else is sympathy for the Devil.

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Capitalism has always been the rule of the people by the oligarchs. You only have two choices, eliminate them or restrict their power.

@The Wizard You summed it up

perfectly.

The biggest problem with this virus is that it is very contagious and it is sneaky about the way it hides in people who feel fine themselves.

Early studies showed values of Ro from 1.4 to 6.66 or even up to 7.23. As you noted, this means that each infected person might give the virus to 1.4 other people on the average or maybe as many as an average of 6.66 people. (Liu et.al. JournalofTravelMedicine, 2020, 1–4)

The spoiled brats wrestling, kissing and partying on the Florida beaches may have even managed to transmit the virus to an average of 7.23 people if they were infected themselves. Some of them said they did not care if they got infected since it is not such a serious illness for young people.

Early Chinese publications said a lot of the infections were transmitted within households. This doubtless assumed reasonable precautions to protect others when in public.

At this point it is probably too late for social tracking, which is honestly something of a relief to me because I doubt the PTB would stop openly tracking us when this is over. As you said we should have stopped this when the number of cases was small. Then case tracking would be practical. Tracking all the contacts of a half a million people and testing the contacts sounds problematic, especially since we do not have adequate personal protective equipment for medical providers, much less for contact trackers.

Telling people the curve is flattening might get better compliance with self-isolation it they think the sacrifices are working. The rate of logarithmic increase is not as great at least. There is not as great an increase on a logarithmic scale.
covid 4.14 confirmed.png

Fourth - The parameter to measure success is the total number of active infections.

Fifth- Our goal should be to decrease R0 to the point that the total number of active cases is flat, and then past that to where they are decreasing with time. Anything else is sympathy for the Devil.

Absolutely right.

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Hawkfish's picture

@ScienceTeacher

It helps to use a trailing window on the exponential growth coefficient. You can then compute the doubling time from that.

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We can’t save the world by playing by the rules, because the rules have to be changed.
- Greta Thunberg

@Hawkfish
I have been trying to figure out ways to get people to realize that we need to work together to get through this epidemic. That makes it clear for people who don't really have an intuitive grasp of logarithms.

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Hawkfish's picture

@ScienceTeacher

I’m updating it every day and tweaking the visuals.

(Also a shout out to @JtC for making embedding things like this possible!)

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We can’t save the world by playing by the rules, because the rules have to be changed.
- Greta Thunberg

CB's picture

There is also a discussion of pre-symptomatic cases. Contact tracing is paramount to finding these people.

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@CB
I was not that worried about this coronavirus until I found out that we are not even testing all the suspected cases, much less their contacts. We do not even know if someone has Covid-19 or some other respiratory problem. Excess flu deaths later in the flu season may have been early Covid-19 deaths, but right now who knows.

It totally blows my mind that there was no contact tracing when this first arrived in the US.
Then they told us not to even used homemade masks to prevent the spread of this disease. Masks to contain droplets are not rocket science. Presymptomatic transmission is not unusual for respiratory viruses and the Chinese did rush scientific papers into publication about their problems containing this epidemic.

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Roy Blakeley's picture

@ScienceTeacher It was obvious to me that widespread testing was going to be necessary to contain the virus. Chinese scientists published the sequence of the virus and details of testing by RT-PCR in early Jan. Designing primers for RT-PCR tests is pretty easy in any case, but they included primer sequences, reverse transcriptase details and real-time PCR conditions.

We had ample time to get ready, but we blew it. The CDC decided to make its own test that didn't work out, and initially they were requiring that samples be sent to Atlanta for analysis (SOP for the flu but crazy as hell for this) which slowed things down. Then after poo-pooing the disease, Trump promised that we would have abundant test kits, but we still don't have test kits. To me this amounts to negligent homicide.

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Cassiodorus's picture

who will get sick and die and we will only know about it a lot later.

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"Scab of a nation, driven insane" -- Frank Zappa

@Cassiodorus
Just consider the "debate" (not really, nobody is debating) raging elsewhere on this site, over whether the Deep State or CCP or SPECTRE or K.A.O.S. is artificially boosting the death counts. Well, currently the number of deaths being ascribed to Covid-19 in New York State is pretty close to the normal average mortality rate in New York State -- about 5000 per week. So unless every damned body showing up in the morgue is being counted as a Covid-19 death, we know that this disease is killing a whole lot of people for real. And no, every damned body showing up in the morgue is not being labeled Covid-19. In particular, the ones showing up at the morgue without first making a stop in a hospital are not being counted as Covid-19, even though plenty of them are (including nursing home deaths), because nobody's going to "waste" a test kit on a dead body.

So, notwithstanding a photo of an empty waiting room, or the fact that the early shutdown in Washington State has been a serious blessing for Tacoma, we can all be sure that when the counting is over, there will have been a big mortality bump in New York State (and in Italy, France, Spain and the UK -- all nations where the reported Covid-19 deaths have hovered in the vicinity of 50% of normal non-Covid-19 expected mortality for those nations). And I fully expect to then have it explained to me, by people know nothing about virology, epidemiology, genomics, or etiology (I've added a new one), that all those extra deaths weren't Covid-19 at all, they were collateral damage of the hysterical hyper-response to Covid-19. And I'll just be like, "Uh-huh".

Meanwhile, my Deep State handlers have ordered to me to slip y'all this high quality Deep State Covid-19 agit-prop. I'd feel bad about it, but since everyone at c99p is well aware that there's a photo circulating of some empty chairs in an ER waiting room, I'm sure they'll all be able to see right through Dr. B's ruse.

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The earth is a multibillion-year-old sphere.
The Nazis killed millions of Jews.
On 9/11/01 a Boeing 757 (AA77) flew into the Pentagon.
AGCC is happening.
If you cannot accept these facts, I cannot fake an interest in any of your opinions.

@UntimelyRippd

And I fully expect to then have it explained to me, by people know nothing about virology, epidemiology, genomics, or etiology (I've added a new one), that all those extra deaths weren't Covid-19 at all, they were collateral damage of the hysterical hyper-response to Covid-19. And I'll just be like, "Uh-huh".

Would you accept biology, biochemistry, and bioinformatics?

That doesn't mean that the PTB are not bungling in almost every way to contain this epidemic. This still reminds me of the Reagan response to HIV. As long as this is seen as just removing undesirable surplus population types they are not likely to make much effort at controlling it.

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@ScienceTeacher

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5 users have voted.

The earth is a multibillion-year-old sphere.
The Nazis killed millions of Jews.
On 9/11/01 a Boeing 757 (AA77) flew into the Pentagon.
AGCC is happening.
If you cannot accept these facts, I cannot fake an interest in any of your opinions.

@ScienceTeacher @ScienceTeacher

you bio-science conversant types would care to weigh in on this:

Logistical and Technical Exploration into the Origins of the Wuhan Strain of Coronavirus (COVID-19)
Posted on January 31, 2020 by harvard2thebighouse

This report is the product of a collaboration between Dr. Karl Sirotkin, a retired professional scientist with dozens of peer-reviewed publications and 30 years of experience in genomic sequencing and analysis, who worked at the Theoretical Biology Division of the Los Alamos National Laboratory and later helped design several ubiquitous bioinformatic software tools, as well as a former NSA counterterrorism analyst. It considers whether the Wuhan Strain of coronavirus (COVID-19) is the result of naturally emergent mutations against the possibility that it may be a bio-engineered strain – directly altered by genetic manipulation, subject to artificially-guided evolutionary selection, or both – most likely released into the public by accident ...

For the benefit of those of us wallowing in ignorance.

Explicated better than I can during this (University of Pittsburgh Medical School Professor of Neuro-Biology) dude's bike commute:

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@Blue Republic
This virus doesn't look like something engineered for germ warfare. It probably was a naturally occurring accident, but there is a believable possibility that it escaped from a lab working on vaccine research against SARS. Accidental releases of pathogens from labs do occasionally happen. (For example the last smallpox death occurred in the UK as a result of a lab accident after smallpox had been eradicated. The director of the lab was so distraught he committed suicide.)

[A] study compared the sequence of the spike protein -- a key protein responsible for getting the virus into mammalian cells -- of the new coronavirus to that of HIV-1, noting unexpected similarities. Although the authors withdrew this preprint manuscript after scientific criticism, it spawned rumors and conspiracy theories that the new coronavirus could have been engineered in a lab. Yang Zhang and colleagues wanted to conduct a more careful and complete analysis of SARS-CoV-2 sequences to resolve these issues.

Compared to the previous studies, the researchers used larger data sets and newer, more accurate bioinformatics methods and databases to analyze the SARS-CoV-2 genome. They found that, in contrast to the claim that four regions of the spike protein were uniquely shared between SARS-CoV-2 and HIV-1, the four sequence segments could be found in other viruses, including bat coronavirus.

https://www.biorxiv.org/content/10.1101/2020.02.17.951335v1.full.pdf

The authors of the paper suggesting that the virus causing Covid-19 contains recombinant RNA from HIV have withdrawn their paper so I could not read it.

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Roy Blakeley's picture

@UntimelyRippd and no one on ventilators, but the authorities acted early and vigorously and people in the county are taking social distancing seriously. If this had been done nation wide and, better, if adequate testing had been implemented, we would have hundreds of deaths, not tens of thousands.

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@Roy Blakeley
You don't understand how this works.

Your county has empty ERs, and therefore the whole pandemic meme is a hoax perpetrated on us by the Forces of Darkness!

You're welcome.

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7 users have voted.

The earth is a multibillion-year-old sphere.
The Nazis killed millions of Jews.
On 9/11/01 a Boeing 757 (AA77) flew into the Pentagon.
AGCC is happening.
If you cannot accept these facts, I cannot fake an interest in any of your opinions.

boriscleto's picture

So people are abandoning social distancing in NYC...

In Onondaga County they still only test people with symptoms, so only 500 cases have been confirmed. So social distancing is less than 50%. SUNY Upstate says we have to have 50% distancing until September to flatten the curve enough to keep from overwhelming the hospitals. The guys who live next door don't distance at all. They have get togethers every weekend, I'm pretty sure one of them spends most of his nights at his girlfriend's etc.

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" In the beginning, the universe was created. This has made a lot of people very angry, and is generally considered to have been a bad move. -- Douglas Adams, The Hitch Hiker's Guide to the Galaxy "

@boriscleto
Nobody gives a fuck anymore about his criminal sexual abuse of one (or more?) of Epstein's underage sex slaves.

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9 users have voted.

The earth is a multibillion-year-old sphere.
The Nazis killed millions of Jews.
On 9/11/01 a Boeing 757 (AA77) flew into the Pentagon.
AGCC is happening.
If you cannot accept these facts, I cannot fake an interest in any of your opinions.

boriscleto's picture

@UntimelyRippd The son of King Mario...

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" In the beginning, the universe was created. This has made a lot of people very angry, and is generally considered to have been a bad move. -- Douglas Adams, The Hitch Hiker's Guide to the Galaxy "

@boriscleto
want to waste the joke?

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7 users have voted.

The earth is a multibillion-year-old sphere.
The Nazis killed millions of Jews.
On 9/11/01 a Boeing 757 (AA77) flew into the Pentagon.
AGCC is happening.
If you cannot accept these facts, I cannot fake an interest in any of your opinions.

boriscleto's picture

That Walmart is opening one of 20 drive thru testing centers in Syracuse. But nobody at Walmart thought the Onondaga County Health Department was important enough to notify.

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9 users have voted.

" In the beginning, the universe was created. This has made a lot of people very angry, and is generally considered to have been a bad move. -- Douglas Adams, The Hitch Hiker's Guide to the Galaxy "

@boriscleto
the communities better.

I was frustrated two weeks ago when they had closed two of the three entrances and made us stand together in line to get in. Those of us who wanted to start a garden had to walk to the entrance at the other end of the building, stand in line and walk all the way through the store just to get to the tomato plants. Then we had to repeat the process to pay and to leave. We had a lot more contact with other people than if they had kept all three entrances open.

Closing stores early instead of having them open 24 hours also increases the crowding.

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CB's picture

@ScienceTeacher
Had to go through a maze to get in. I needed garden supplies. They count people going in and subtract them coming out to limit number of people in the store at one time. I give them credit for wiping down basket handles and debit checkout machines. But. they wouldn't take cash - my preferred method for buying everything. Now the revenuers will know I'm growing undocumented veggies. I may have to mount armed surveillance to prevent theft. Stop

Doing a large garden this year. I'm hoping it will keep me out of trouble.

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12 users have voted.
CB's picture

The daily death rate in the US had been trending down over a week from 2,000 per day to about 1,500 or so yesterday. But today's rate shot up to 5,985 and the day is not over. Most of the deaths were from NYC. What the hell is going on - 6,000 deaths in one day? China only had 3,341 deaths total over 3 months.

https://ncov2019.live/

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@CB
The Johns Hopkins website has not posted numbers for today yet so I cannot compare.

Maybe they are reporting all the nursing home and other out-of-hospital losses for the past few weeks?

I hope they have not run out of ventilators and started rationing. It makes me feel sick.

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CB's picture

@ScienceTeacher
on ventilators is 70%. All other info I've read is the death rate s/b about 37%. That's fucking double the normal death rate. Maybe they have to wait too long due to lack of available ventilators, maybe they are not getting sick people into the hospitals quick enough or this virus is exceptionally virulent and damaging to lung tissue.

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@UntimelyRippd @CB

Of Dr. Zelenko and other frontline NY doctors were being followed
(early use of the HCL/Azithromycin/Zinc cocktail for high risk patients)
then the number of people requiring hospital admission and those
requiring ventilators might well be much lower.

There is also concern among doctors that ventilators may be being over-used
and used inappropriately in a significant number of cases.

Some, such as the doctor below suggest that that using them on high pressure settings may be causing lung damage.

This NYC critical care physician suggests that what patients are suffering more resembles altitude sickness than ARDS or conventional pneumonias:

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CB's picture

@Blue Republic
Dr. Roger Seheult explains it in this video.

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CB's picture

@ScienceTeacher
out of ventilators. Trump said yesterday in his press conference he will have "thousands and thousands of ventilators, more than we will need" by the end of April/mid May. Dash 1

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6 users have voted.

@CB
made the virus disappear this Easter. It will be a miracle. Our Fearless Prez said so. On Fox News. So it must be true.

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7 users have voted.
Roy Blakeley's picture

@CB big time. China implemented measures to contain COVID-19. Many jurisdictions in the US, New York being the prime example, acted way too late. Plus, we still don't have enough tests.

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8 users have voted.

@CB -- not additional deaths today. Not previously included in the numbers because while suspected these persons were not tested.

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7 users have voted.

Although there is not much that can change outcomes for people who are already infected with the coronavirus, a community effort to slow the spread of the disease can make a big difference. Isolating ourselves as much as possible, wearing cloth or paper masks when it is essential to leave home, and washing our hands properly can make a real difference.

Well... if the numerous doctors that are using the HCL/Azithromycin/Zinc course are being at all truthful, and the testimonials of recovered patients who received it carry any weight, then there may be a whole lot that can be done to change outcomes for those who become symptomatic.

Question becomes whether or to what extent anything *will* be done.

And for those - apparently a large majority - who remain asymptomatic or suffer only mild symptoms, well, they are not in any real need of having their own outcomes changed, are they?

That does leave a very substantial number of people who are vulnerable and at higher risk should they become infected, but there are legitimate questions about what is appropriate in terms of protecting them. Is the point to protect them until a vaccine comes along? A fair percentage of them - those frail with advanced age, those with serious chronic conditions, for example, will die from those before the vaccine ever comes along. Others may be at high risk for vaccination.

At what point does it continue to make sense to continue to lock down the whole population to delay infecting a relatively tiny percentage of the population that is at risk? As opposed to trying to isolate the at-risk and letting everyone else out to try and resume some semblance of normal and productive lives?

Agree that greatly enhanced testing would help greatly. I think Japan (where I'm at) has only tested 30,000 total - their numbers continue to go up. Switzerland (population 6 or 7 percent of Japan's) was testing 2500 a day back in March and is now up to 6000/day. Their numbers for both new cases and deaths are dropping even though their lockdown was less strict than that in many US states (but they did implement it earlier).

Yes, the social distancing, masks and such can work to slow the spread, but its not like the cavalry is going to be showing up anytime soon so starving or going crazy waiting for them has some shortcomings, strategy-wise.

Situation in Switzerland

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CB's picture

@Blue Republic
as to the efficacy of the HCL/Azithromycin/Zinc treatment? Maybe patients receiving this treatment are part of the very large group of people in which the progression of the disease results in relatively mild and moderate symptoms and who would have recovered on their own w/o any drug treatment whatsoever.

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@CB

There have not been such studies. Way past my bedtime so I'm not going to search out a bunch of links at the moment.

But,

In a recent global survey of 6000 doctors around the world treating COVID-19 HCL was, by a plurality, the most popular treatment.

Hydroxychloroquine is being gone to in a big way in India and Indonesia, is being used in France and China, UK & etc. Dr. Zelenko and some other docs contend that zinc is an important component - it is known to prevent viral replication but can't readily enter cells the HCL apparently enables that and the azithromycin (Z-pack) is to prevent opportunistic bacterial infections.

The exact characteristics of the group that Zelenko initially treated is not clear - about two-thirds were from his community which is mostly Hassidic Jews. But he wasn't just cherry picking mild cases, either. Out of 600 people he declined to treat 400 - excluding those under 60 without co-morbidities or severe symptoms. Of the 200 he did treat, at about two weeks in only half a dozen had had to be admitted to hospital, three of those intubated and no deaths.

There is this:

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@Blue Republic
I really hope clinical outcomes can be improved, but it will take a little bit of time to get through clinical trials of various drugs and any new procedures. If the epidemic can be slowed down maybe the outlook will be much better for the 20% of virus victims with serious cases. If the number of people needing care is decreased they can get the more effective care that is more labor intensive.

The half-baked, erratically-implemented shutdown is much less effective in stopping the epidemic than a coordinated shut down. This will greatly add to the economic pain. This is a time when incompetent leadership is devastating.

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