CORONAVIRUS/COVID-19 NEW MEGA THREAD

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Honestly, how scared should I be right now? What is the likelihood that I will get this virus? What is the likelihood that I will die?

It's about distancing people from each other by quarantines and closures so that we can slow the rate of transmission down enough that hospitals won't be deluged in cases. If they are, seriously ill patients will die from lack of medical attention, like they're doing right now in northern Italy, and like they did in Wuhan. If hospitals don't have enough beds or personnel or equipment during the surge, people who shouldn't have died in the normal course of events WILL DIE from lack of adequate healthcare. It could be you or me, it will most likely be those who are most at-risk, as well as some unlucky healthy and younger patients who lie forgotten in some hospital corridor.

Virology explanation:
This is a new virus that just jumped the species barrier and as a result is not adapted to humans. Because of that it's more likely to kill its host or make it very ill, instead of living quietly and replicating. The consequence is that there is a characteristic spike in cases, like for all pandemics (that are all due to new strains maladapted to humans). THE SPIKE IS WHAT'S LETHAL TO THE COMMUNITY. Healthcare system are not made to receive so many patients at once, and they break down from over-solicitation. This will happen if we don't implement closures right now.

I hope you understand.

- microbiologist

guess who's back...back again...

Yes, and? You'd rather people not be informed?
I wonder why you find experts so distasteful. Perhaps you are jealous of expertise? You can always go back to school.

DP. I agree with the microbiologist and think her posts are informative, but she’s not really an “expert” in this field. She seems knowledgeable, analytical, and informed but not an “expert” in epidemiology/public health. I’m sure she’d agree with that assessment.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Honestly, how scared should I be right now? What is the likelihood that I will get this virus? What is the likelihood that I will die?

It's about distancing people from each other by quarantines and closures so that we can slow the rate of transmission down enough that hospitals won't be deluged in cases. If they are, seriously ill patients will die from lack of medical attention, like they're doing right now in northern Italy, and like they did in Wuhan. If hospitals don't have enough beds or personnel or equipment during the surge, people who shouldn't have died in the normal course of events WILL DIE from lack of adequate healthcare. It could be you or me, it will most likely be those who are most at-risk, as well as some unlucky healthy and younger patients who lie forgotten in some hospital corridor.

Virology explanation:
This is a new virus that just jumped the species barrier and as a result is not adapted to humans. Because of that it's more likely to kill its host or make it very ill, instead of living quietly and replicating. The consequence is that there is a characteristic spike in cases, like for all pandemics (that are all due to new strains maladapted to humans). THE SPIKE IS WHAT'S LETHAL TO THE COMMUNITY. Healthcare system are not made to receive so many patients at once, and they break down from over-solicitation. This will happen if we don't implement closures right now.

I hope you understand.

- microbiologist

It’s more complex than that. Automatically quarantining people without knowledge of the mode of transmission, and without considering the psychological and social effects, which impact on compliance, may be ineffective and it may be unwarranted.

The example of SARS and the attempt in Toronto to control it with mass quarantine - 100 people for every SARS case. It didn’t work in the case of SARS because it was being transmitted mostly at hospitals, not in the community, it was infectious only when the patient was clinically ill, and only about half the people complied. It was health care workers providing care for these patients, before PPE became standard, who were at risk. SARS led to the now mandatory practice of PPE in care facilities.

BUT, this is NOT to say that it shouldn’t be done for Coronavirus. All I’m saying that we should NOT jump to the conclusion that mass quarantine will stop an outbreak.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2094974/#B6

An outbreak should meet the following three criteria for quarantine to be a useful measure of disease control:

first, people likely to be incubating the infection must be efficiently and effectively identified;

second, those people must comply with the conditions of quarantine; and

third, the infectious disease in question must be transmissible in its presymptomatic or early symptomatic stages.

The use of quarantine in the Toronto outbreak failed on all three counts.

SARS quarantine in Toronto was both inefficient and ineffective. It was massive in scale. Toronto public health authorities quarantined approximately 100 people for each SARS case, while Beijing public health quarantined about 12 people for each SARS case. An analysis of the efficiency of quarantine in the Beijing outbreak conducted by the American Centers for Disease Control and Prevention concluded that quarantine could have been reduced by two-thirds (four people per SARS case), without compromising effectiveness if authorities had "focused only on persons who had contact with an actively ill SARS patient" (2).

- MD, MHS, but not an epidemiologist, who works with geriatric patients in Canada

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Can someone explain how China handled this “well” when they deliberately allowed thousands to attend the Wuhan banquet when they knew they had a problem. Those people thereafter dispersed allowing this to get much worse. That’s is insane.

The people that are defending China here are insane as well.

They work for the gover

What happened to this poster.. ending middle sentence.. scary...

They work for the gover

[Anonymous]

So the testing and contact tracing are just as important as quarantining.

[Anonymous]

How many years are you willing to sacrifice from YOUR life for the sake of the economy?

My dad is 72 and spent the last year fighting cancer and heart failure. Stem cell replacement, you name it. Do I just shrug and decide that since he no longer contributes to the economy he's not work saving? He's just a burden on social security and medicare after all.

Close schools now!

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Honestly, how scared should I be right now? What is the likelihood that I will get this virus? What is the likelihood that I will die?

It's about distancing people from each other by quarantines and closures so that we can slow the rate of transmission down enough that hospitals won't be deluged in cases. If they are, seriously ill patients will die from lack of medical attention, like they're doing right now in northern Italy, and like they did in Wuhan. If hospitals don't have enough beds or personnel or equipment during the surge, people who shouldn't have died in the normal course of events WILL DIE from lack of adequate healthcare. It could be you or me, it will most likely be those who are most at-risk, as well as some unlucky healthy and younger patients who lie forgotten in some hospital corridor.

Virology explanation:
This is a new virus that just jumped the species barrier and as a result is not adapted to humans. Because of that it's more likely to kill its host or make it very ill, instead of living quietly and replicating. The consequence is that there is a characteristic spike in cases, like for all pandemics (that are all due to new strains maladapted to humans). THE SPIKE IS WHAT'S LETHAL TO THE COMMUNITY. Healthcare system are not made to receive so many patients at once, and they break down from over-solicitation. This will happen if we don't implement closures right now.

I hope you understand.

- microbiologist

guess who's back...back again...

Yes, and? You'd rather people not be informed?
I wonder why you find experts so distasteful. Perhaps you are jealous of expertise? You can always go back to school.

DP. I agree with the microbiologist and think her posts are informative, but she’s not really an “expert” in this field. She seems knowledgeable, analytical, and informed but not an “expert” in epidemiology/public health. I’m sure she’d agree with that assessment.

back again, back, back, back ...back again ...

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Honestly, how scared should I be right now? What is the likelihood that I will get this virus? What is the likelihood that I will die?

It's about distancing people from each other by quarantines and closures so that we can slow the rate of transmission down enough that hospitals won't be deluged in cases. If they are, seriously ill patients will die from lack of medical attention, like they're doing right now in northern Italy, and like they did in Wuhan. If hospitals don't have enough beds or personnel or equipment during the surge, people who shouldn't have died in the normal course of events WILL DIE from lack of adequate healthcare. It could be you or me, it will most likely be those who are most at-risk, as well as some unlucky healthy and younger patients who lie forgotten in some hospital corridor.

Virology explanation:
This is a new virus that just jumped the species barrier and as a result is not adapted to humans. Because of that it's more likely to kill its host or make it very ill, instead of living quietly and replicating. The consequence is that there is a characteristic spike in cases, like for all pandemics (that are all due to new strains maladapted to humans). THE SPIKE IS WHAT'S LETHAL TO THE COMMUNITY. Healthcare system are not made to receive so many patients at once, and they break down from over-solicitation. This will happen if we don't implement closures right now.

I hope you understand.

- microbiologist

It’s more complex than that. Automatically quarantining people without knowledge of the mode of transmission, and without considering the psychological and social effects, which impact on compliance, may be ineffective and it may be unwarranted.

The example of SARS and the attempt in Toronto to control it with mass quarantine - 100 people for every SARS case. It didn’t work in the case of SARS because it was being transmitted mostly at hospitals, not in the community, it was infectious only when the patient was clinically ill, and only about half the people complied. It was health care workers providing care for these patients, before PPE became standard, who were at risk. SARS led to the now mandatory practice of PPE in care facilities.

BUT, this is NOT to say that it shouldn’t be done for Coronavirus. All I’m saying that we should NOT jump to the conclusion that mass quarantine will stop an outbreak.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2094974/#B6

An outbreak should meet the following three criteria for quarantine to be a useful measure of disease control:

first, people likely to be incubating the infection must be efficiently and effectively identified;

second, those people must comply with the conditions of quarantine; and

third, the infectious disease in question must be transmissible in its presymptomatic or early symptomatic stages.

The use of quarantine in the Toronto outbreak failed on all three counts.

SARS quarantine in Toronto was both inefficient and ineffective. It was massive in scale. Toronto public health authorities quarantined approximately 100 people for each SARS case, while Beijing public health quarantined about 12 people for each SARS case. An analysis of the efficiency of quarantine in the Beijing outbreak conducted by the American Centers for Disease Control and Prevention concluded that quarantine could have been reduced by two-thirds (four people per SARS case), without compromising effectiveness if authorities had "focused only on persons who had contact with an actively ill SARS patient" (2).

- MD, MHS, but not an epidemiologist, who works with geriatric patients in Canada

I don’t know what an MHS is, but this sounds informative.

[Anonymous]

Anonymous wrote:So the testing and contact tracing are just as important as quarantining.

Maybe more important.

And testing has little cost, especially in a country like the US with a top notch biomedical industry.

It is absolute malpractice that the US is not doing 20,000 tests a day right now.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Honestly, how scared should I be right now? What is the likelihood that I will get this virus? What is the likelihood that I will die?

It's about distancing people from each other by quarantines and closures so that we can slow the rate of transmission down enough that hospitals won't be deluged in cases. If they are, seriously ill patients will die from lack of medical attention, like they're doing right now in northern Italy, and like they did in Wuhan. If hospitals don't have enough beds or personnel or equipment during the surge, people who shouldn't have died in the normal course of events WILL DIE from lack of adequate healthcare. It could be you or me, it will most likely be those who are most at-risk, as well as some unlucky healthy and younger patients who lie forgotten in some hospital corridor.

Virology explanation:
This is a new virus that just jumped the species barrier and as a result is not adapted to humans. Because of that it's more likely to kill its host or make it very ill, instead of living quietly and replicating. The consequence is that there is a characteristic spike in cases, like for all pandemics (that are all due to new strains maladapted to humans). THE SPIKE IS WHAT'S LETHAL TO THE COMMUNITY. Healthcare system are not made to receive so many patients at once, and they break down from over-solicitation. This will happen if we don't implement closures right now.

I hope you understand.

- microbiologist

It’s more complex than that. Automatically quarantining people without knowledge of the mode of transmission, and without considering the psychological and social effects, which impact on compliance, may be ineffective and it may be unwarranted.

The example of SARS and the attempt in Toronto to control it with mass quarantine - 100 people for every SARS case. It didn’t work in the case of SARS because it was being transmitted mostly at hospitals, not in the community, it was infectious only when the patient was clinically ill, and only about half the people complied. It was health care workers providing care for these patients, before PPE became standard, who were at risk. SARS led to the now mandatory practice of PPE in care facilities.

BUT, this is NOT to say that it shouldn’t be done for Coronavirus. All I’m saying that we should NOT jump to the conclusion that mass quarantine will stop an outbreak.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2094974/#B6

An outbreak should meet the following three criteria for quarantine to be a useful measure of disease control:

first, people likely to be incubating the infection must be efficiently and effectively identified;

second, those people must comply with the conditions of quarantine; and

third, the infectious disease in question must be transmissible in its presymptomatic or early symptomatic stages.

The use of quarantine in the Toronto outbreak failed on all three counts.

SARS quarantine in Toronto was both inefficient and ineffective. It was massive in scale. Toronto public health authorities quarantined approximately 100 people for each SARS case, while Beijing public health quarantined about 12 people for each SARS case. An analysis of the efficiency of quarantine in the Beijing outbreak conducted by the American Centers for Disease Control and Prevention concluded that quarantine could have been reduced by two-thirds (four people per SARS case), without compromising effectiveness if authorities had "focused only on persons who had contact with an actively ill SARS patient" (2).

- MD, MHS, but not an epidemiologist, who works with geriatric patients in Canada

I don’t know what an MHS is, but this sounds informative.

Master of Health Sciences

[Anonymous]

Anonymous wrote:Honestly, how scared should I be right now? What is the likelihood that I will get this virus? What is the likelihood that I will die?

High. You are stressing. This puts you in the highest risk
Just kidding. Depends how old are you, what other health issues do you have and how overworked and sleep depraved are you. All factors.
In theory 3.4 people die in. 100. In practice this changes up or down depending on the contributing factor.

If you are 22 female, non smoking, no known health issues, well rested and athletic, you are i n low risk group.

If you are a 69 male, smoker, overweight, with high blood pressure, congestive heart failure, diabetes and you drink to the point of liver damage, and your kidneys require dialysis, then stay home tape the door and pray.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Honestly, how scared should I be right now? What is the likelihood that I will get this virus? What is the likelihood that I will die?

High. You are stressing. This puts you in the highest risk
Just kidding. Depends how old are you, what other health issues do you have and how overworked and sleep depraved are you. All factors.
In theory 3.4 people die in. 100. In practice this changes up or down depending on the contributing factor.

If you are 22 female, non smoking, no known health issues, well rested and athletic, you are i n low risk group.

If you are a 69 male, smoker, overweight, with high blood pressure, congestive heart failure, diabetes and you drink to the point of liver damage, and your kidneys require dialysis, then stay home tape the door and pray.

This hasn't been how it is playing out in other countries. It sounds reasonable but it's not totally accurate.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Honestly, how scared should I be right now? What is the likelihood that I will get this virus? What is the likelihood that I will die?

It's about distancing people from each other by quarantines and closures so that we can slow the rate of transmission down enough that hospitals won't be deluged in cases. If they are, seriously ill patients will die from lack of medical attention, like they're doing right now in northern Italy, and like they did in Wuhan. If hospitals don't have enough beds or personnel or equipment during the surge, people who shouldn't have died in the normal course of events WILL DIE from lack of adequate healthcare. It could be you or me, it will most likely be those who are most at-risk, as well as some unlucky healthy and younger patients who lie forgotten in some hospital corridor.

Virology explanation:
This is a new virus that just jumped the species barrier and as a result is not adapted to humans. Because of that it's more likely to kill its host or make it very ill, instead of living quietly and replicating. The consequence is that there is a characteristic spike in cases, like for all pandemics (that are all due to new strains maladapted to humans). THE SPIKE IS WHAT'S LETHAL TO THE COMMUNITY. Healthcare system are not made to receive so many patients at once, and they break down from over-solicitation. This will happen if we don't implement closures right now.

I hope you understand.

- microbiologist

It’s more complex than that. Automatically quarantining people without knowledge of the mode of transmission, and without considering the psychological and social effects, which impact on compliance, may be ineffective and it may be unwarranted.

The example of SARS and the attempt in Toronto to control it with mass quarantine - 100 people for every SARS case. It didn’t work in the case of SARS because it was being transmitted mostly at hospitals, not in the community, it was infectious only when the patient was clinically ill, and only about half the people complied. It was health care workers providing care for these patients, before PPE became standard, who were at risk. SARS led to the now mandatory practice of PPE in care facilities.

BUT, this is NOT to say that it shouldn’t be done for Coronavirus. All I’m saying that we should NOT jump to the conclusion that mass quarantine will stop an outbreak.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2094974/#B6

An outbreak should meet the following three criteria for quarantine to be a useful measure of disease control:

first, people likely to be incubating the infection must be efficiently and effectively identified;

second, those people must comply with the conditions of quarantine; and

third, the infectious disease in question must be transmissible in its presymptomatic or early symptomatic stages.

The use of quarantine in the Toronto outbreak failed on all three counts.

SARS quarantine in Toronto was both inefficient and ineffective. It was massive in scale. Toronto public health authorities quarantined approximately 100 people for each SARS case, while Beijing public health quarantined about 12 people for each SARS case. An analysis of the efficiency of quarantine in the Beijing outbreak conducted by the American Centers for Disease Control and Prevention concluded that quarantine could have been reduced by two-thirds (four people per SARS case), without compromising effectiveness if authorities had "focused only on persons who had contact with an actively ill SARS patient" (2).

- MD, MHS, but not an epidemiologist, who works with geriatric patients in Canada

I strongly disagree with your post, because closures and quarantines have been shown to prevent the inexorable increase in Covid-19 cases in other countries. We have OBSERVABLE, OBJECTIVE DATA that it works.
And I cannot stress this enough -
Closures and quarantines are our ONLY TOOL right now.

Your post dangerous, because as a health professional, you should have very clear, simple, direct messaging.
Close schools and workplaces. Quarantine patients and exposed people. Tracing their contacts. Disinfection of public places, washing hands.
Every measure other countries have implemented that have turned the epidemic around.

If you want to air your knowledge of SARS, great. But SARS is a different beast altogether in terms of propagation and mortality rate and as a doctor you should know that perfectly well and not muddy the waters for people who may not understand this.

Please do not post that closures and quarantines won't work for Covid-19. They have been shown to work. We will only save lives if we're all working together as a team.

Come on.

[Anonymous]

With all the MPH degree holders in this country you’d think we’d have a better handle in this situation. Sure don’t!!

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Honestly, how scared should I be right now? What is the likelihood that I will get this virus? What is the likelihood that I will die?

It's about distancing people from each other by quarantines and closures so that we can slow the rate of transmission down enough that hospitals won't be deluged in cases. If they are, seriously ill patients will die from lack of medical attention, like they're doing right now in northern Italy, and like they did in Wuhan. If hospitals don't have enough beds or personnel or equipment during the surge, people who shouldn't have died in the normal course of events WILL DIE from lack of adequate healthcare. It could be you or me, it will most likely be those who are most at-risk, as well as some unlucky healthy and younger patients who lie forgotten in some hospital corridor.

Virology explanation:
This is a new virus that just jumped the species barrier and as a result is not adapted to humans. Because of that it's more likely to kill its host or make it very ill, instead of living quietly and replicating. The consequence is that there is a characteristic spike in cases, like for all pandemics (that are all due to new strains maladapted to humans). THE SPIKE IS WHAT'S LETHAL TO THE COMMUNITY. Healthcare system are not made to receive so many patients at once, and they break down from over-solicitation. This will happen if we don't implement closures right now.

I hope you understand.

- microbiologist

It’s more complex than that. Automatically quarantining people without knowledge of the mode of transmission, and without considering the psychological and social effects, which impact on compliance, may be ineffective and it may be unwarranted.

The example of SARS and the attempt in Toronto to control it with mass quarantine - 100 people for every SARS case. It didn’t work in the case of SARS because it was being transmitted mostly at hospitals, not in the community, it was infectious only when the patient was clinically ill, and only about half the people complied. It was health care workers providing care for these patients, before PPE became standard, who were at risk. SARS led to the now mandatory practice of PPE in care facilities.

BUT, this is NOT to say that it shouldn’t be done for Coronavirus. All I’m saying that we should NOT jump to the conclusion that mass quarantine will stop an outbreak.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2094974/#B6

An outbreak should meet the following three criteria for quarantine to be a useful measure of disease control:

first, people likely to be incubating the infection must be efficiently and effectively identified;

second, those people must comply with the conditions of quarantine; and

third, the infectious disease in question must be transmissible in its presymptomatic or early symptomatic stages.

The use of quarantine in the Toronto outbreak failed on all three counts.

SARS quarantine in Toronto was both inefficient and ineffective. It was massive in scale. Toronto public health authorities quarantined approximately 100 people for each SARS case, while Beijing public health quarantined about 12 people for each SARS case. An analysis of the efficiency of quarantine in the Beijing outbreak conducted by the American Centers for Disease Control and Prevention concluded that quarantine could have been reduced by two-thirds (four people per SARS case), without compromising effectiveness if authorities had "focused only on persons who had contact with an actively ill SARS patient" (2).

- MD, MHS, but not an epidemiologist, who works with geriatric patients in Canada

This isn’t SARS. It’s much more contagious. Quarantine is different from social distancing. Every single reputable public health expert is urging greater social distancing.

[Anonymous]

The strange outcome of the whole situation is that if the quarantine has been imposed early, people would ignore it and violate , but look at Italy, once people started dropping like flies left and right they cleaned the stores and begged for closings. People clearly won’t hide from a hurricane until the roof is not starting to fly. This is no different. We are experiencing it here too. The more cases the more people get up from the sofa and buy the boatload of the TP pasta and rice.