2019-nCoV / Corona virus Pt 2

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I detest Sam Harris but this is an excellent interview with one of Johns Hopkins' leading virologists who gives a bit of hope things won't be as bad as many others have posited - including me:



It's an hour long, but only the first 20 minutes matter.

I'm hoping the doctor is right on every point!
 
I don't think little of you, you were making me frustrated.

What kind of mics are you using and are there instructions for cleaning that particular mic?
All that other stuff, H2O2, bleach and alcohol can damage metal and other surfaces. First, you need something safe for your equipment. That information generally comes from manufacturer websites and written information.

These are all 58's that the rehearsal renters tend to use. They get the hell beaten out of them regularly, so if hydrogen peroxide dulls or strips the paint, I am fine with that.

Normally I soak them in alcohol once a week. Regular isopropyl alcohol does not even kill the foam inserts in the grilles.
 
OK... Full lockdown here in Guate. All schools closed, all sports suspended, all gatherings of more than 100 people banned, all Semana Santa activities closed, all entrance from Americans, Mexican, Canadian, and Europeans prohibited. Panic buying starting in Guatemala City and will probably hit my area in the next week.
 
OK... Full lockdown here in Guate. All schools closed, all sports suspended, all gatherings of more than 100 people banned, all Semana Santa activities closed, all entrance from Americans, Mexican, Canadian, and Europeans prohibited. Panic buying starting in Guatemala City and will probably hit my area in the next week.

It looks the entire world will be closed up by the end of the week. I hope you're ok down there - not so much from the virus but the political fallout and loss of income.
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I do keep wondering if action on the virus will impact the clowns attacking each other in various part of the world. Be a shame if a virus slowed down wars.
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Yesterday's new case increase was only 35, compared to almost 30% the day before.

I imagine a lot of that kind of anomaly will be seen, because some systems will lag on test results when they're busy saving lives.
 
I have a small team working on a plant shutdown in KSA. They just announced an International flight ban. This kind of action is spreading and I guess by next weekend there will not be much international travel
 
In Singapore the government has carried out a terrific response on messaging and community action. But now the first phase has passed under control I see no option but a complete travel ban and back to fortress Singapore. But without a vaccine everything is just a delay tactic (which as we can see in Italy is a high value tactic)
 
Singaporean schools have been kept open, which was a huge political gamble, because when Singapore was high on the list of infected countries there was a high demand to close them.

I supported keeping the schools open as for the last 3 years every child carries a thermometer to school and since January this year temperatures are recorded twice a day and written in the child's school diary. In addition international travel declarations for school children has been a requirement for at least 3 years. So my logic was that these simple checks would protect the community.

But now I see a counter argument that children might catch and spread the virus but show no symptoms and do not become sick. Lockdown.
 
You don't need hand sanitizers. You need general quarantine. Close everything. Stay at home. That's what helped in China. Italy introduced western version of it week ago, it's still too soon to tell if it helped, we will know in another week. If it's not enough, we will have to right out ban people from leaving their houses, and enforce it, just as China did. Italy is week deep in healthcare collapse. What will come next week when there is 10 times more cases there ? Most other European countries are not learning a bit. They are all waiting for the situation to get bad. And US is following the trend. General quarantine with first case in the country, or even sooner. That's the best step. And let's hope some non-totalitarian version can be found which works.

The problem is that quarantine is not a cure. When you come out of quarantine you remain susceptible. At this point we are not going to eradicate the virus. So you come out and get infected. You have delayed the infection not prevented it. So why delay?

If you do it right you can smear the peak, preventing health services being overloaded. If you do it wrong for us in the North, you push the peak into autumn and you then have it merging into the winter surge in respiratory infections and make things worse. Ideally you want to smear the peak so it is winding down in September.

In theory if you knew a cure or vaccine was coming soon this would justify a quarantine until help arrived. Even the imminent discovery in vitro means months of accelerated human testing then the need to make billions of doses. This is not going to happen before the Northern winter.

So the question is are you best to allow a 'controlled burn' now? Or try to keep a lock down quarantine until a cure / vaccine is available in months, with the devastation of the economy that would mean? Is that even possible? Will people put up with being locked in with their children for months with twice weekly exits for food shopping, and only essential workers allowed to travel for work? The UK is potentially asking over 70's to self isolate for 3 months. This is the length of lock down potentially needed and might just delay the peak not spread it.

From a purely pragmatic PoV it may be the best and most practical response to allow the epidemic to progress but slow it by social distancing and social isolation for anyone with a flu like illness. Spread the peak, but have it passing before winter.

The predicted peak was about 50% of illness occurring over 3 weeks, if the peak could be spread to 9 weeks then this is a three fold reduction in the rate of admission to hospital and demand for beds.

ETA To have an impact school closures need to be for 3 - 4 months. As Covid 19 is not significantly affecting children unlike e.g. flu the benefit of school closures is not great.

I had wondered about geographic cycling of quarantine, so you geographically smeared the peak, allowing the peak to occur at different times in different cities. This then requires a non-country wide but local policy and mutual assistance between areas that are less and more severely affected.
 
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Yes correct, delay is the important factor. For example USA can calculate based on their containment policy how many additional ICU beds they need, when they need them, select the locations, build them. The numbers don't lie.
 
I think this is fairly clear. The danger is overrunning the health care system so that all patients who require ICU treatment cannot recieve it.

The way to slow down the spread is reduction of travel, social distancing, use of hand sanitisers, hand washing, use of face masks in an appropriate way.
 
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The problem is that quarantine is not a cure. When you come out of quarantine you remain susceptible. At this point we are not going to eradicate the virus. So you come out and get infected. You have delayed the infection not prevented it. So why delay?

If you do it right you can smear the peak, preventing health services being overloaded. If you do it wrong for us in the North, you push the peak into autumn and you then have it merging into the winter surge in respiratory infections and make things worse. Ideally you want to smear the peak so it is winding down in September.

In theory if you knew a cure or vaccine was coming soon this would justify a quarantine until help arrived. Even the imminent discovery in vitro means months of accelerated human testing then the need to make billions of doses. This is not going to happen before the Northern winter.

So the question is are you best to allow a 'controlled burn' now? Or try to keep a lock down quarantine until a cure / vaccine is available in months, with the devastation of the economy that would mean? Is that even possible? Will people put up with being locked in with their children for months with twice weekly exits for food shopping, and only essential workers allowed to travel for work? The UK is potentially asking over 70's to self isolate for 3 months. This is the length of lock down potentially needed and might just delay the peak not spread it.

From a purely pragmatic PoV it may be the best and most practical response to allow the epidemic to progress but slow it by social distancing and social isolation for anyone with a flu like illness. Spread the peak, but have it passing before winter.

The predicted peak was about 50% of illness occurring over 3 weeks, if the peak could be spread to 9 weeks then this is a three fold reduction in the rate of admission to hospital and demand for beds.

ETA To have an impact school closures need to be for 3 - 4 months. As Covid 19 is not significantly affecting children unlike e.g. flu the benefit of school closures is not great.

I had wondered about geographic cycling of quarantine, so you geographically smeared the peak, allowing the peak to occur at different times in different cities. This then requires a non-country wide but local policy and mutual assistance between areas that are less and more severely affected.

Quarantine is the controlled burn option. Nothing is going to stop the spread, the best we can hope for is slowing it down.

The Italy situation makes it very clear. If the virus spread fast enough, people who might have otherwise survived will not get lifesaving care because the entire health system is overloaded.
 
Keeping schools open uses the children as a vector to infect adults. This is a good policy to ramp up the number of infected adults to your target level.

...and there is a target level - it's not "as low as possible" - if you wish to get most people infected and recovered (or dead) before the northern winter, then there's no point wasting the first month or so with a very low level of infection.

UK policy (and maybe Sweden too) seems to be to keep the schools open till the target level of infection is obtained, and simultaneously have a war-footing style effort to build new ventilator machines, and train temporary medics on how to intubate patients and operate the ventilators.
 
We know how many ICU beds are needed, just use the numbers. USA and others had time so build them.
 
Apparently Matt Hancock has been saying he wants over 70s to self-isolate for up to four months.

This is presumably so that the healthier population can become infected and create herd immunity.

If the idea is to quarantine the vulnerable rather than the entire population, then maybe the idea does make more sense than it appeared to me at first.

That said, it still seems to me a gamble and some critics have pointed out that we don’t know enough about the disease to know the immunological properties of the disease.
 
Apparently the new screening requirements at US airports have caused massive backlogs of people ... thousands of people jammed shoulder to shoulder in confined spaces for hours.

Perhaps some of them were infected with the coronavirus before they even disembarked.

I wonder how many were newly infected at the airport (obviously they showed no symptoms when they finally got to the health station)?
 
Keeping schools open uses the children as a vector to infect adults. This is a good policy to ramp up the number of infected adults to your target level.

...and there is a target level - it's not "as low as possible" - if you wish to get most people infected and recovered (or dead) before the northern winter, then there's no point wasting the first month or so with a very low level of infection.

UK policy (and maybe Sweden too) seems to be to keep the schools open till the target level of infection is obtained, and simultaneously have a war-footing style effort to build new ventilator machines, and train temporary medics on how to intubate patients and operate the ventilators.

Unlike flu (for which children are definitely super spreaders) there is no evidence children are significant vectors for SARS CoV 2. There have been no school centred outbreaks. Transmission seems to be adult to adult. I am not saying you are wrong but the evidence so far is school closures will have a small impact on spread, and a large economic impact including loss of health service staff who will need to stay home to look after their own personal vectors.

ETA I have a friend who is an epidemiologist who wanted to call her daughter Vekta!
 
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Apparently Matt Hancock has been saying he wants over 70s to self-isolate for up to four months.

This is presumably so that the healthier population can become infected and create herd immunity.

If the idea is to quarantine the vulnerable rather than the entire population, then maybe the idea does make more sense than it appeared to me at first.

That said, it still seems to me a gamble and some critics have pointed out that we don’t know enough about the disease to know the immunological properties of the disease.
Yeah, like how long does immunity last, once you’ve gotten infected and have recovered?

Or: how quickly will evolution lead to new strains, for which immunity to other/older strains is no, or little, help?

Or: what if this coronavirus gets together with a handful of others (e.g. flu) and they have a gene swapping party?

On the side of certainty: we’ll start to find out in 2020, and will learn a lot by 2025 (it’s too late to stop this coronavirus from becoming humanity’s most recent fellow traveler, unlike SARS).
 
Quarantine is the controlled burn option. Nothing is going to stop the spread, the best we can hope for is slowing it down.

The Italy situation makes it very clear. If the virus spread fast enough, people who might have otherwise survived will not get lifesaving care because the entire health system is overloaded.

The problem is that if you overdo quarantine then the epidemic peak shifts to winter which is worse. You need to quarantine enough and at the right time to smear the peak but not delay it significantly. So you probably want to lock down 3 - 4 weeks before the expected peak, early enough to flatten the peak but not too soon that you delay it much. Expected peak if we do nothing in the UK is 4 weeks end June / early July. Perhaps the best is a peak of 8 - 12 weeks July / August / September. Hopefully all the cabin crew and cafe workers who are now unemployed can help out in hospitals or on farms since there will be no migrant workers to help with harvests.
 
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