The One Covid-19 Science and Medicine Thread

[JeanTate]

Quoted from this post (my hilite).

Fifth published by fiveThirtyEight earlier today*: "Experts Think The U.S. COVID-19 Death Toll Will Hit 50,000 By The End Of April"

Some snippets (the survey on which the article is based was "conducted April 13 and 14"):

"The expert consensus is that the U.S. will have reported around 47,000 COVID-19 deaths by May 1, with a 90 percent chance of having between 32,000 and 82,000.

This is very close to the latest forecast from the Institute for Health Metrics and Evaluation at the University of Washington, which projects roughly 51,000 deaths by May 1, with an uncertainty range from about 28,000 to 112,000."

Frightening that by today (17 April) the US death toll has blown past 28k, and by tomorrow will almost certainly have exceeded 32k.

"For five weeks, surveyed experts were asked what factors led to the difference between their best-case and worst-case estimates in longer-term death forecasts. The answers have had a common refrain: They can’t perfectly predict what stay-at-home orders will be enacted, how long they will last, and how well people will follow those orders. That last issue became particularly salient this week as protesters in Michigan, Ohio and North Carolina organized in opposition to their state’s stay-at-home orders."

I rather doubt that anyone's model could accurately include the effects of those sorts of protests.

"At the time the survey was conducted, three states — New York, New Jersey and Michigan — had reported more than 1,000 COVID-19 deaths. As of Thursday, Louisiana, Massachusetts and Illinois have also passed that threshold.

The experts were asked how many states will report more than 1,000 deaths by May 1. They estimated that the most likely number was between eight and 11 states, with a nearly 1 in 3 chance that at least 12 states would report that many deaths."

From this WaPo site, as of earlier today (19 April), covid-19 deaths:

1: 17,627 New York NY
02: 4,249 New Jersey NJ
03: 2,308 Michigan MI
04: 1,560 Massachusetts MA
05: 1,267 Louisiana LA
06: 1,259 Illinois IL
07: 1,148 California CA
08: 1,105 Pennsylvania PA
09: 1,086 Connecticut CT

Then ...
10: 748 Florida FL
11: 677 Georgia GA
12: 630 Washington WA
13: 545 Indiana IN
14: 483 Texas TX

Perhaps a clearer indication of the havoc wrought is deaths per 100k of population; this may give an idea of what may happen in states other than NY:

NY: 90
NJ: 48
CT: 30
LA: 27
MI: 23
MA: 23
DC: 13
RI: 13
IL: 10
PA: 9
WA: 9
IN: 8
CO: 7
DE: 7
GA: 7
...
FL: 4
...
CA: 3
...
TX: 2

 

[alfaniner]

I don't know if the entirety of the Jacksonville beaches were re-opened. The photos I saw of the crowds seemed to show improper social distancing. Yes, the photos show a crowded beach.

The photos and video always show a ground-level view, often with a telephoto lens. This tends to crowd very distant things together in the images, making the beaches look a lot more crowded than they actually are. When they switch to the drone or aerial shot, the actual distancing is quite evident.

But yes, from a side view the shots of people for example on the boardwalk does show that many of them are not maintaining their distances. I think for couples and small families that's ok, but I'd often see converging groups of people which are a no-no.

 

[Skeptic Ginger]

Yes, people making their own is good. Once it became public policy then people might expect that there would be provision of 'approved' masks, there would be a demand for free provision for the poor or disabled who were unable to manufacture their own masks. In the US where their is less expectation of public assistance and more on personal reliance then expecting people to make or buy their own masks would probably be acceptable, in the UK there would be an expectation for a significant state provision. E.g. making and posting out 7 masks a week to everyone (ie 420,000,000 masks a week) is an enormous logistic issue. If we are going for re-usable masks then we need a policy on daily cleaning. Cloth masks that could be boil cleaned nightly, hung out to dry, and used the next day might be the best solution.

You don't have to sterilize cloth masks. Soap and water kills COVID 19. As for free masks, goodness people are sewing them and donating them to others all over the country.

As for masks used by healthcare workers, there has been a successful effort to validate sterilizing for reuse here.

The supplies here in the Seattle area are holding up. There was a call for masks and it turned out all the dental offices that were shut down had unused N95s, some construction companies did, and people had them in their emergency supplies (we needed them when Mt St Helens erupted, the volcanic dust was deadly).

People started showing up at donation sites set up to collect new/unused masks.

 

[Skeptic Ginger]

It can hurt in a couple of ways. The most stupid is people who wear them thinking it makes them and others invincible and ignoring all social distancing rules.

But the thing that I don't see being hammered home enough in the media is that the masks can be a transmission vector themselves. You need to wash the mask after you've used it, and wash your hands before putting it on and taking it off. And don't touch it once it is on. It can encourage face-touching just by being uncomfortable.

As an addendum to the above - they're a temporary thing. Once any droplets that the mask catches have evaporated, the virus is left on the mask, and viruses are small enough to be drawn through the cloth by your breath. So if you have it on for too long, then it can be a way to funnel the virus directly in to your mouth and nose.

Masks can be effective, but without people understanding masks and using them correctly, they have the potential to be dangerous.

This is assuming the mask is protecting the wearer. If the mask is to protect others from the person wearing them, everyone wearing masks makes sense.

And think about it: if the outside of the mask becomes contaminated, that would be with droplets which would otherwise have hit that person's face directly.

 

[Skeptic Ginger]

Good to have you back, by the way!

Thank you.

 

[Skeptic Ginger]

Absolutely! And this is why with mask-wearing, education is important. How to wear, and look after, a mask is as important as how to wash your hands. Plenty of people think they know how to wash their hands, but have been learning recently that their way of washing their hands was completely inadequate.

What is still wrong, though, imho, is promoting the idea that masks are completely ineffective. It seems that the evidence goes against that!

Yes, yes and yes.

 

[Skeptic Ginger]

I have seen advice against gloves. The argument is that your skin's natural secretions can help the virus' lipids to break down, whereas rubber gloves just transmit it from place to place.

How true that is I don't know.

That's bunk. Good grief.

Yes the gloves can transmit the virus to places you touch. So can your hands. The idea is to consider the gloves contaminated and act appropriately. Then wash your hands when you take them off.

 

[Skeptic Ginger]

There seems to be a significant possibility that wearing face masks might turn out to be the most significant thing that we can do to slow the spread, which is "interesting" since, at least in the US, governments for 2 months claimed that wearing face masks was at best useless and at worse would increase the chance of getting infected. Most of the recent writings have been that only a small percentage of transmission has occurred from people touching contaminated surfaces, but in a month "they" could go back to saying that it is a significant means of transmission.

I know (I was screaming about this earlier on). And people are having a very hard time letting go of what they originally "learned" about the masks.

 

[Squeegee Beckenheim]

This is assuming the mask is protecting the wearer.

Most of it was, but some is otherwise relevant. An ill-fitting mask worn by someone who is ignoring social distancing rules can still be a danger.

But, yes, I was assuming that everybody in this thread was already aware that the primary purpose of mask-wearing is to prevent everybody from the mask-wearer rather than the other way around. I was answering the question asked, which was what harm can people wearing a mask do. The idea that there is no potential harm in wearing a mask is both incorrect and dangerous, and people should be aware of that and adjust their behaviour accordingly.

And think about it: if the outside of the mask becomes contaminated, that would be with droplets which would otherwise have hit that person's face directly.

Yes. I made the same point myself a couple of days ago in one of this thread's predecessors.

 

[Planigale]

Simple science can be reassuring.

Arrived at work today to find we have new face masks. Cheap looking Chinese masks rather than our usual masks we had been using. Nurses unhappy about masks, are they really waterproof masks, how impermeable are they? So I filled one up with water like a little basin and suspended it over a bowl. No leakage over several minutes. Nurses immensely relieved. Photos of experiment sent out to ward WhatsApp. Rather than having ties like our previous masks which meant they could be tied tight and on top of my head scarf, these have earloops, and tend to hang a bit loose. This is not so bad for us girls as we can hook them over our buns (for any adolescent boys - hairbuns), or use hair clips, but the guys have short hair. For me it's a bit of a pain since it either means messing with my head scarf everytime I'm putting on or taking off a mask, or losing the headscarf which I like as it covers all of my head and neck not covered by mask and visor. So off with the head scarf and tying my hair up for the shift (something I don't bother with if it is tucked in a scarf), which is safer than fiddling with my scarf repeatedly I think. There was some concern that my having to take my head scarf off was culturally or religiously insensitive and offers to find better masks. Since I now only wear a scarf for hygiene or fashion reasons I preferred showing solidarity and wearing the same mask as the rest of the ward staff.

When people are under stress little changes can be unduly upsetting. Even though our ward has always taken high risk viral infections and the staff have been used to dealing with these issues previously when there would only be one or two patients in negative pressure rooms we would gown up and be in FFP3 masks whereas now the ward is full of patients we wear aprons and gloves and surgical type masks.

 

[Giordano]

That's bunk. Good grief.

Yes the gloves can transmit the virus to places you touch. So can your hands. The idea is to consider the gloves contaminated and act appropriately. Then wash your hands when you take them off.

Actually I am not so certain. Skin has a variety of anti-microbials and I can imagine that some skin oils for example might help disrupt viral envelopes to some degree. Or not. I just don’t think it is established one way or another.

 

[casebro]

Which tests will these be?

Where will the results be published?


Serological test results will certainly add to the knowledge we have about SARS-COV-2 and covid-19.

The biggy is L.A. county, 1,000 random tests. You will need your surgical mask tied quite a bit too tightly to not hear about it. The pre-release is that there are more people out there that had it and never even knew it. Some info: https://news.usc.edu/168810/usc-cov...nswers-questions-about-testing-in-l-a-county/

 

[marting]

The biggy is L.A. county, 1,000 random tests. You will need your surgical mask tied quite a bit too tightly to not hear about it. The pre-release is that there are more people out there that had it and never even knew it. Some info: https://news.usc.edu/168810/usc-cov...nswers-questions-about-testing-in-l-a-county/

Interesting.

The company also tested 371 COVID-19-negative patients, with only two false positives. We also validated these tests in a small sample at a lab at Stanford University. When we do our analysis, we will also adjust for false positives and false negatives.

So this study will have the same limitation re false positives. That is that there is a 5% chance the false positive rate of this test is greater than 1.6% and a 5% chance it is below 0.1% given that the manufacturer's data and the additional known negatives the researchers used.

However, this uncertainty will reduce over time since they expect to sample test people as the COVID progresses.

It's also pretty obvious that another way to get better stats on asymptomatic ratios would be to test populations that have very high case percentages. NY, MA, and other places like that would provide more accurate results. Are there researchers doing that with the same test?

 

[dann]

Isn't water the whole point of going to the beach?

Ever heard of bikini chicks?!

 

[dann]

I'd have thought that there was a risk in the mouth in the same way that there is in the nose - there's a mucus membrane there. If the mouth can be a potential vector for the cold (which it can), then I see no reason why it can't be a vector for this coronavirus.

It can, of course. But one of the problems with testing, i.e. false negatives, in the the case of this particular virus is that at one point of the disease, swabs from the mouth don't contain any virus even though the virus is still in the lungs. (And it is much more difficult to get swabs from that region, of course.)
This may also explain the case of the choir unlike the case of the wedding: Singers are breathing much more deeply than guests at an ordinary wedding (and probably spitting a lot more, too).
Which makes me think: This could also be the reason why people in professional sports seem to have been so good at infecting each other!

 

[pipelineaudio]

How is NYC still getting upwards of 5000 cases per day? I got called out a lot for posting pictures of way too many people way too crowded together on subways still over the last week.

lots of claims of "essential"

I don't buy it. I think hard choices have to be made. I know I certainly had to shut my business down here and we are nowhere near that packed

I see lots of pictures and videos of people still, unmasked hanging out partying together

For those who think that every single new yorker is practicing perfect social distancing, staying at home if they are non essential and not congregating unnecessarily, how do you explain so many cases still being added every day?

 

[Skeptic Ginger]

Actually I am not so certain. Skin has a variety of anti-microbials and I can imagine that some skin oils for example might help disrupt viral envelopes to some degree. Or not. I just don’t think it is established one way or another.

Decades of infection control research about pathogens spread on healthcare worker hands begs to differ. And what are we doing all this ******* hand washing for?

Prove it.

Why are you guys doing this, spreading word of mouth hypotheses? What happened to our evidence based medicine crowd? Dr Hall where are you?

 

[pipelineaudio]

This is assuming the mask is protecting the wearer. If the mask is to protect others from the person wearing them, everyone wearing masks makes sense.

And think about it: if the outside of the mask becomes contaminated, that would be with droplets which would otherwise have hit that person's face directly.

I've gotten to the point on social media where I added mask deniers to the general category off covid 19 deniers. There just isn't enough time for all that

 

[Skeptic Ginger]

It can, of course. But one of the problems with testing, i.e. false negatives, in the the case of this particular virus is that at one point of the disease, swabs from the mouth don't contain any virus even though the virus is still in the lungs. (And it is much more difficult to get swabs from that region, of course.)
This may also explain the case of the choir unlike the case of the wedding: Singers are breathing much more deeply than guests at an ordinary wedding (and probably spitting a lot more, too).
Which makes me think: This could also be the reason why people in professional sports seem to have been so good at infecting each other!

Gawd! Here's another one.

Enters via the mouth. You inhale, voilá into the trachea it goes.


SG is fuming again. Off to get some chocolate ice cream after the next post.

 

[Skeptic Ginger]

How is NYC still getting upwards of 5000 cases per day? I got called out a lot for posting pictures of way too many people way too crowded together on subways still over the last week.

lots of claims of "essential"

I don't buy it. I think hard choices have to be made. I know I certainly had to shut my business down here and we are nowhere near that packed

I see lots of pictures and videos of people still, unmasked hanging out partying together

For those who think that every single new yorker is practicing perfect social distancing, staying at home if they are non essential and not congregating unnecessarily, how do you explain so many cases still being added every day?

Early on, Cuomo started using their own tests outside of the CDC tests.

Business Insider march 20: A mix-and-match coronavirus-testing strategy has allowed New York to screen 32,000 people — far more than any other state

Vox a week ago: New York City secures its own supply of 100,000 coronavirus tests per week

Still not enough but it needs to be taken into consideration when comparing state case numbers.