2019-nCoV / Corona virus Pt 2

[JeanTate]

To all of you so diligently working the figures on the COVID death rate, has it dawned on anyone that some deaths of younger persons with no risk factors in the US almost certainly occurred without COVID testing?

For me, yes.

As has the uncertainty around how long immunity will last, the extent to which this varies with (just about everything); how quickly, and how, the virus will mutate; how effective a vaccine will be; whether effective symptom treatments will become widely available (and when); how vulnerable people will be - to all kinds of infections and conditions - once they’ve recovered (especially if they had it bad); and so on.

 

[a_unique_person]

Trump just gave his Corona Response a 10 out of 10.

Tweets or it didn't happen

 

[marting]

To all of you so diligently working the figures on the COVID death rate, has it dawned on anyone that some deaths of younger persons with no risk factors in the US almost certainly occurred without COVID testing?

I think that's a very safe bet.

The major reason for testing is to determine the extent and locales of community spread so that the degree of social distancing that needs to be done can be appropriately tailored. Right now we are flying blind and so the social distancing needing to be done has to be done broadly with significant consequences to the economy. A whole lot less damage would have been done had we had reasonable testing capability weeks ago instead of sometime next week or the week after.

 

[JeanTate]

But those people will still have been presenting with Covid-19-like symptoms (respiration problems, high fever, etc), so I'd find it hard to believe that if they went through hospital admission with those symptoms, the hospital wouldn't have tested them. And if they stayed and died at home, there'd have to be an autopsy, which would almost certainly detect the lung scarring/fibrosis along with post-mortem blood tests. I suppose that these sorts of Covid-19 deaths might lag by a couple of days in their detection and reporting, but I find it hard to believe that they would (as a rule) be missed altogether.

Wouldn’t it be nice if we in the US had a healthcare system like the NHS?

It’s very easy to find statements from ER doctors, say, here in the US, which you’d find hard to believe (may be happening less often now, but for many hospitals the protocol permitted tests only if the patient had recently been in China, say; symptoms alone were not sufficient to authorize a definitive test).

If the dead young person were wealthy, an autopsy may be normal; if they were an undocumented homeless drug addict? Less likely (check out Pence’s record, when he was a Governor).

 

[zooterkin]

While mention of Trump's physician being a qualified osteopath was relevant, further discussion of the efficacy or otherwise of osteopathy in general does not belong in this thread.

Thank you.

Replying to this modbox in thread will be off topic  Posted By: zooterkin

 

[Ampulla of Vater]

Wouldn’t it be nice if we in the US had a healthcare system like the NHS?

It’s very easy to find statements from ER doctors, say, here in the US, which you’d find hard to believe (may be happening less often now, but for many hospitals the protocol permitted tests only if the patient had recently been in China, say; symptoms alone were not sufficient to authorize a definitive test).

If the dead young person were wealthy, an autopsy may be normal; if they were an undocumented homeless drug addict? Less likely (check out Pence’s record, when he was a Governor).

It’s not the hospital permitting or not permitting testing, it’s the health department, AIUI. My daughter is an NP at an urgent care and over the last 2 days she has wanted to test 3 people but 2 were not permitted to be tested by the state health department, despite one flying in from Seattle and another whose husband just returned home from Italy about 10 days or so ago. All 3 had symptoms. They claimed the 2 patients did not meet their guidelines and suggested they get tested at Labcorp instead. So what is wrong or sub-par with the tests by Labcorp?
The one who was permitted to be tested was, in fact, positive.

Moreover, the health department had a total of only 250 tests as of Friday afternoon (thus the rationing).

There are no N95 masks to be had anywhere either. My daughter has been using surgical masks on both her and any symptomatic patients. What a mess.

 

[The Atheist]

How do you "protect the most vulnerable"? This seems like a bit of double talk.

Cut visitors, ensure workers wear masks and gloves at all times, are constantly tested and keep the disease away from them. Ones living on their own, much the same - only mix with others equally protected, get groceries & medicine delivered, etc.

It's going to be a lot easier to find people to do that than find ICU and staff to intubate and monitor them.

And even if the actual mortality rate is 1% that's still 10x that of the flu. 0.5%... 5x that of the flu. That's a lot of dead people.

I've been doing the maths since the start.

All that said, I don't think there's only one way to deal with this pandemic. But like many experts there's no real consensus as to which method will turn out the best.

South Korea & Singapore seem to have it fairly sorted, and they were very early starters, in both infection and testing/tracking. They were top of the list and now aren't anywhere it.

They just have to stay holed up in their home to avoid infecting anyone with the virus they can't get tested for.

Another coworker is also sick with a fever, and does not seem to be able to get a test either.

That's outrageous, but does fit what I've been suspecting all along - that this is everywhere and numbers are an order of magnitude higher than announced.

Tests are not really that important. As long as you can breath by yourself, doctors can't do anything for you anyway.

Yeah they can. Not a lot, I admit, but oxygen & intubation are saving lives. You also probably won't die of a secondary infection, and one university hospital says it can even get the rate of death from cytokine storm down from about 100% to 28%.

To all of you so diligently working the figures on the COVID death rate, has it dawned on anyone that some deaths of younger persons with no risk factors in the US almost certainly occurred without COVID testing?

Nope, and John covers most of the reasons why that isn't the case right here:

But those people will still have been presenting with Covid-19-like symptoms (respiration problems, high fever, etc), so I'd find it hard to believe that if they went through hospital admission with those symptoms, the hospital wouldn't have tested them. And if they stayed and died at home, there'd have to be an autopsy, which would almost certainly detect the lung scarring/fibrosis along with post-mortem blood tests. I suppose that these sorts of Covid-19 deaths might lag by a couple of days in their detection and reporting, but I find it hard to believe that they would (as a rule) be missed altogether.

Even if they didn't get tested in hospital, with no precautions being taken, EMT and paramedic staff would have shown up lots of infections by now.

 

[The Atheist]

.... she has wanted to test 3 people but 2 were not permitted to be tested by the state health departmen...

That's just insane.

But not surprising, because we're doing exactly the same here. If you don't fit the very narrow profile, they will not test.

 

[dudalb]

ROn Paul removes any doubt about his sanity or lack thereof with his take on the Corona Virus.

http://www.ronpaulinstitute.org/arc...us-hoax/?utm_source=quora&utm_medium=referral

 

[JeanTate]

<snip>

Even if they didn't get tested in hospital, with no precautions being taken, EMT and paramedic staff would have shown up lots of infections by now.

You might consider re-reading some of SG’s posts, on her experience in WA (Washington state).

A) there’s a delay
B) younger people (EMTs etc) may not have thought they were ill
C) not clear, after the fact, which was the person who had covid-19
Etc.

Less likely today; certainly happened, more than once, in the previous week or two.

 

[The Atheist]

B) younger people (EMTs etc) may not have thought they were ill

Considering she specifically mentioned deaths of young, healthy people, I'm going to take a wild guess and say they knew they were ill.

 

[JeanTate]

Thanks.

It’s not the hospital permitting or not permitting testing, it’s the health department, AIUI. My daughter is an NP at an urgent care and over the last 2 days she has wanted to test 3 people but 2 were not permitted to be tested by the state health department, despite one flying in from Seattle and another whose husband just returned home from Italy about 10 days or so ago. All 3 had symptoms. They claimed the 2 patients did not meet their guidelines and suggested they get tested at Labcorp instead. So what is wrong or sub-par with the tests by Labcorp?
The one who was permitted to be tested was, in fact, positive.

Moreover, the health department had a total of only 250 tests as of Friday afternoon (thus the rationing).

There are no N95 masks to be had anywhere either. My daughter has been using surgical masks on both her and any symptomatic patients. What a mess.

Those outside the US may not fully appreciate how, um, decentralized healthcare is here.

In addition to States, some cities (etc) have their own health departments (yes, with their own rules).

Hospitals may have a lot of latitude, especially if they’re privately owned.

And availability of testing may vary, within a state, across a hospital system (still common but hopefully becoming less so).

 

[dudalb]

Thanks.


Those outside the US may not fully appreciate how, um, decentralized healthcare is here.

In addition to States, some cities (etc) have their own health departments (yes, with their own rules).

Hospitals may have a lot of latitude, especially if they’re privately owned.

And availability of testing may vary, within a state, across a hospital system (still common but hopefully becoming less so).

On the other hand, state and local official can step up and take action if the feds won't.
Call it redundency.
Yes, I am not a fan of an all powerful central government. I will take federalism...(the real stuff, not the crap the Federalist Socitry peddels).

 

[crescent]

Late last week of my coworkers flew cross country and back for her grandfather's funeral. Today both she and her wife have coughs and fevers. She called he GP, but they could not recommend her for a test because she didn't have any known contact with anyone with nCov, and neither coworker nor coworker's wife are in any high risk categories. They just have to stay holed up in their home to avoid infecting anyone with the virus they can't get tested for.

Another coworker is also sick with a fever, and does not seem to be able to get a test either.

Same thing is still happening here. Are you in WA?

Colorado, just west of Denver. The second coworker snowboards often, and some of the ski areas have been hit by this. She mostly seems to use the ski areas that have not yet been in the news for having the virus.

Vail seems to be the epicenter of one mini-outbreak. They have now closed all ski areas, although the government didn't order that to be done until the two largest ski companies closed down on their own already.

 

[JeanTate]

Considering she specifically mentioned deaths of young, healthy people, I'm going to take a wild guess and say they knew they were ill.

Go.
Read.
SG’s.
Posts.
(The relevant ones, that is).

The EMTs etc who came in contact with the sick young person may have become infected, but may not have realized it. And so spread the virus themselves. All the time thinking they were healthy (or at least not ill).

 

[pipelineaudio]

There seems to still be some serious disagreement among the highest experts on whether or not there are truly asymptomatic cases. I think the Chinese said that eventually if they have it, they develop symptoms. What's the latest on this?

 

[JeanTate]

Thanks.

On the other hand, state and local official can step up and take action if the feds won't.
Call it redundency.
Yes, I am not a fan of an all powerful central government. I will take federalism...(the real stuff, not the crap the Federalist Socitry peddels).

Indeed.

Conversely, such governments may not act at all.

As Pence’s did, in Indiana, over an HIV/AIDS outbreak. Despite well understood guidelines for how to deal with such a thing.

Quite a lot of similarities with what we’ve seen from the US Federal government, for quite a few weeks now ...

 

[Darat]

Trump just gave his Corona Response a 10 out of 10.

That is jaw dropping. Only a 10 out of 10! Pah it should have been a hundred out of 10, that's what they say.

 

[JeanTate]

There seems to still be some serious disagreement among the highest experts on whether or not there are truly asymptomatic cases. I think the Chinese said that eventually if they have it, they develop symptoms. What's the latest on this?

I’m not an expert. Nor do I try to keep up this.

However, I’ve seen nothing to suggest that anyone, except a true medical expert, could tell if young Alex’s symptoms were covid-19, or any one of the many conditions young children pick up at kindergarten, child care center, or school.

A parallel: how readily does a young child with covid-19 pass it on to their parents, teachers, grandparents, ...?

 

[dudalb]

That is jaw dropping. Only a 10 out of 10! Pah it should have been a hundred out of 10, that's what they say.

Man, DOnnie is just handing out ammo to the Democrats...