COVID-19 Outbreak Information Updates (Reboot) [over 150.000,000 US cases (est.), 6,422,520 US hospitilizations, 1,148,691 US deaths.] (11 Viewers)

[Saint_Ward]

I agree. It's almost a distraction and time-waster to quibble over spacing when the fact is the air is not exchanged, just circulated over and over in that one little room all day long. Add in the A/C which reduces humidity and no or ill-fitting masks and you've got the perfect recipe for transmission.

I"m in an office all day, with people of questionable hygiene.. they're better lately, but still... We have colds sweep through here all the time.

So far.. not a one. Just some allergies.

Not sure how many classrooms have windows they can open, but if parents work with their kids to wear masks... I'm not quite freaking out. The issue is you really can't have a band class, unless you're always outside. Sports are probably out of the question. It's still a lost season for the kids.

And the areas of the country that have strong mask usage, already have kids doing this mostly well... would do the best in school. The places that aren't doing it well, you're asking for trouble in schools. So, that's probably why we see this a bit differently.

 

[RazorOye]

I'm assuming 6-feet, indoors, mandatory masks for us

 

[No2DC]

The one area I thought they'd consider some flexibility is the 6 ft rule, so long as everyone is in a mask. Like, is 3 feet objectively worse? If you're in an enclosed room, the spacing isn't as critical (my personal opinion, not sure there is any research to support or deny).

Ventilation is another issue I'm concerned with, particularly if you work in an older building.

 

[St. Geezy]

The other site has a better view. See, this is actually somewhat positive for Florida, they should show more data...

The deaths, while slightly growing so far, are way below what it was in April. This could be significant, with the age demographics lowering. Otherwise, it would get really, really, ugly.

Sorry to keep harping on this, but it is worth noting that since the data I posted yesterday, the new CDC numbers indicate that the Florida "Pneumonia pandemic" has claimed 66 more lives, bringing their total up to 6,051 through half of 2020; this after averaging 2,870 over the past five years.

Here is the link (it seems that this updates every 2 to 3 days, and has a bit of lag behind the Worldometers site we all follow):

Provisional Death Counts for Coronavirus Disease 2019 (COVID-19)

National Center for Health Statistics

www.cdc.gov

Personally, I am at the point now where I am no longer just looking at COVID totals, as it seems pretty clear that there is a lot more to the story than meets the eye.

 

[SaintsFanInLA]

From a Facebook post. Take it for what it's worth.

Rick Loftus, MD
Coachella Valley, CA
Posted 7/2/2020
Update on COVID-19
——-
“I'm in a hotspot hospital in a hotspot region (Coachella Valley, Inland Empire, CA). We just converted the entire second floor of our hospital to COVID-19 care yesterday, July 1.
We have 65 inpatients with COVID-19 in a hospital with 368 beds. It is the same at our other 2 hospitals in the Valley.
We spent yesterday deciding the ethical way to divide up limited remdesivir (30 patients' worth) for the hospital patients.
My 20 incoming interns for our IM resident were exposed to COVID 2 weeks ago during their computer chart training; apparently 100% of our computer trainers had COVID19. One intern tested positive 7 days later and I insisted we re-test them all again, as there are almost certainly other cases with minimal symptoms.
I raided my household and took my entire supply of face shields to the hospital for the residents to wear on their first day, and I paid $1000 of my own money to equip all of my residents with medical-grade face shields. I require all residents to wear a surgical mask or N95 with face shield if they are within 6 feet of another human, patient or coworker.
Roughly 20% of our inpatients die. Only 30% of our ventilated patients survive. (We try to avoid ventilation at all costs. Some people insist on being full code and decompensate despite high flow with face mask, proning, dexamethasone, antibiotics, and a cocktail of famotidine, zinc, Vitamin D, Vitamin C, NAC, and melatonin--we throw everything we can at each case, so long as it won't hurt them.)
My administrative assistant, who sits adjacent to the interns, just went home with COVID symptoms. Her test is pending.
In the Southwest, we are experiencing catastrophic exponential growth. I have had multiple families--siblings, parent-child, spouses--admitted with COVID-19. I had a 31 year old come in satting 78% on room air; he had been sequestering himself in his bedroom for a week to avoid infecting his elderly parents, with whom he lived. His sister, the only person he saw outside his immediate household in the 10 days prior to onset of fever, cough, and dyspnea, had also had fevers but had tested "negative" at our other large hospital so he thought it was safe to visit her. (Sigh. The Quest PCR test is about 80% sensitive, we think--it had emergency approval, so sensitivity data was not required. The Cepheid rapid COVID PCR test is 98.5% sensitive but is in short supply due to limited reagent availability.)
I'm glad some of you are sheltered from what unbridled COVID-19 looks like. It's a hell show. This is *July*. What do you think my hospital will look like in winter?...
This is real. Doctors in places with proper public health responses will see few cases in their hospitals--like UCSF--but let me tell you something: The laws of physics and biology don't change. If you're in an unaffected region, an introduction and poor governance and low use of physical distancing and masks will give you an exponential increase in no time flat (i.e. 2-4 weeks). That's pandemic math. And 20% of the population infected needs a hospital. You *will* run out of beds with an unbridled pandemic. There is almost ZERO pre-existing immunity to SARS-CoV-2. There may be some "priming" of T-cell responses due to exposure to other "benign" beta-coronaviruses, but we have no idea if that explains the 20-40% of people who seem to get minimal symptoms. Asymptomatic infected persons, however, can, and do, spread COVID to those who die from it.
By the way: I've seen scary looking CT scans of the lungs that look like terrible interstitial pneumonia in a patient who had ZERO symptoms and SaO2 94% on room air. She came in for palpitations and the intern overnight got a chest CT for cardiac reasons. We didn't know it was COVID until her test came back 36 hours later. So "asymptomatic" does NOT mean "no biological activity." The virus replicates furiously in people who feel fine. Kids can spread this as easily as grown ups, even if they feel okay.
Related: I've talked to two previously healthy patients ages 32 and 44 who are 3 and 4 months, respectively, post their acute COVID. They continue to have cough, nightsweats, fever, fatigue. How many survivors have "post-COVID syndrome"? We don't know. Less than 20% but we're not sure. I've asked my hospital to allow me to establish a post-COVID clinic to care for and study survivors. Both NIH and UW are planning similar efforts based on my dialogues with them.
Autopsies show anoxic brain injury in many patients who died of COVID, not to mention microthrombi throughout the lungs and megakaryocytes in massive infiltrations in their hearts and other organs. People get heart failure, lung fibrosis, and permanent kidney injury from COVID-19. This is a disease of the vascular systems, and it can affect any organ, with lungs and kidneys being especially at risk.
In early May, thanks to lockdown, our census of 55 came down to 10 COVID cases, and for a brief moment, I actually had hope that the worst nightmares I had about COVID, as a biohazard virology-trained hospitalist, would not come to pass. Then we re-opened, without test/trace/isolate systems anywhere close to adequate. Eight weeks ago my county decided to make masks "optional," despite 125 doctors begging them not to do that. Now we're worse than we were in April. And it's getting worse every day.
You wanna see if COVID is real? Come walk on my COVID ward with me. It's real. Hearing people talk about it as if it's an exaggeration is, well, rage-inducing, honestly. Denial is the most common reaction to a pandemic. Denial is how the US will wind up with 1.1 million deaths instead of 30,000. I saw AIDS denialists get killed by their belief that HIV "isn't real, it's a pharma conspiracy of the medical industrial complex." Yeah, right, if you say so. I watched patients with those beliefs die.
The hardest part about this is, every new case I treat exposes me. I have assiduous hot zone technique. But no technique is bulletproof. If you keep exposing me to case after case, eventually, the virus will get through my defenses. I'm a 50 year old hypertensive. I don't expect to do well if I get infected. For now, I keep going to work. I'm one of the few pushing forward on COVID clinical trials, basic science, public health messaging, and diagnostic studies at my hospital. I feel a responsibility to keep going. I wake up with nightmares every morning at 4am. But I'm going to keep going for now. I feel very alone a lot of the time. People are not taking this seriously, and it's costing lives. -R
"Everything we do before a pandemic will seem alarmist. Everything we do after a pandemic will seem inadequate. This is the dilemma we face, but it should not stop us from doing what we can to prepare. We need to reach out to everyone with words that inform, but not inflame. We need to encourage everyone to prepare, but not panic." — Michael O. Leavitt, 2007
--
Richard A. Loftus, MD
"Never be afraid to raise your voice for honesty and truth and compassion against injustice and lying and greed. If people all over the world...would do this, it would change the earth."
--William Faulkner

 

[Sun Wukong]

Research is showing that, contrary to what many have been saying, wearing a mask individually cuts down your chances of contracting covid by over half.

Wearing a mask cuts own risk of novel coronavirus by 65 percent, experts say | Fox News

Health experts have stressed the importance of wearing masks to limit the possibility of infections others with COVID-19, but a range of new research now suggests they also protect the wearer, according to a report Monday.

www.foxnews.com

 

[faceman]

I think it's coming, honestly. Our city was resistant to it, because we haven't been hit hard and all the trends have been downward. Finally, it became a matter of prevention and keeping numbers down as well as preparing for likelihoods of prevention for months from now - good practice now, so that they become habits later.

Canada is now experiencing the longest days of the year. Toronto has 16 hours of sunlight at the current time. I believe the studies that show exposure to sun helps the bodies immune system fight off this virus. We'll know more when the days start becoming much shorter in October

 

[bclemms]

Canada is now experiencing the longest days of the year. Toronto has 16 hours of sunlight at the current time. I believe the studies that show exposure to sun helps the bodies immune system fight off this virus. We'll know more when the days start becoming much shorter in October

It hasn't been completely proven and that was in SARS but there is a lot of anecdotal evidence that increased vitamin D from sun exposure can lessen the impacts. Plus the virus does not like UV light.

I think the winter and fall will answer all of these questions. If the virus is that much more contagious and severe cases are more common then masks and social distancing will likely at best keep us running at similar rates. If we open schools up with this amount of virus running through the US then we're in big trouble. I personally think we're headed for a hell of a decision. Shut down to slow the virus or economic fallout that could be catastrophic. We had our chance to limit the economic fallout and virus, I don't think it is either or the next time. I sure hope I'm wrong.

 

[Goatman Saint]

One of our members posted that his mother, a retired RN, had been contacted regarding returning to work. He was afraid she'd say yes. I think it was @Goatman Saint?

Rough times. I do all patient treatments in the patients rooms. I wear gown, mask, gloves and face shield. the gowns do not breathe and patient rooms are warm. I go through 3-4 gowns per day.

Be careful when you say you want to lose a few lbs

Yeah it was me. Fortunately cases in Montana didn’t explode and she has been playing it safe. Ow that’s she’s thought about it a bit more, she’s changed to not a good idea.

 

[St. Widge]

The one area I thought they'd consider some flexibility is the 6 ft rule, so long as everyone is in a mask. Like, is 3 feet objectively worse? If you're in an enclosed room, the spacing isn't as critical (my personal opinion, not sure there is any research to support or deny).

I tend to think that 3 feet vs. 6 feet doesn't matter much indoors in an enclosed room but only because I think the new evidence is that the virus stays in the air for a long period of time in an unventilated room so 6 feet is almost as bad as 3 feet. Being in an enclosed room that doesn't have some sort of massive ventilation system isn't really a good idea without an N95 or better mask.

 

[St. Geezy]

I did some more studying of trends late last night, using the Worldometers data, and there are few more things that standout significantly as anomalies.

It is really amazing what can be gleaned once the numbers reach a certain point and trends form, and I can state with a very, very high degree of certainty that these five things are simply not possible, even if you factor in the proverbial death lag:

• Florida has 232,718 cases, but only 4,009 deaths
• Texas has 229,619 cases, but only 2,944 deaths
• Georgia has 103,890 cases, but only 2,922 deaths
• Tennessee has 55,986 cases, but only 685 deaths
• South Carolina has 48,909 cases, but only 884 deaths

Unless most of these states' citizens have different DNA than the rest of the world's, or their populations are remarkably younger (they're not), these numbers are clearly not possible. I am not going to say its intentional, but at a minimal, something is not being tabulated properly.

So, with that in mind, I decided to once again take a look at the Pneumonia and Influenza death data. We have already covered Florida and Texas yesterday, so I will now do Georgia, South Carolina, and Tennessee:

So, once again, either COVID deaths are intentionally being labeled as P&I, or we have an absolutely massive Pneumonia/Influenza pandemic on our hands in specific states but not others.

It doesn't take an Epidemiology degree or being a medical expert to figure these things out. All you have to do is be good at math and simple data analytics.

Here are my sources, in case anyone would like to check my work:

United States COVID - Coronavirus Statistics - Worldometer

United States Coronavirus update with statistics and graphs: total and new cases, deaths per day, mortality and recovery rates, current active cases, recoveries, trends and timeline.

www.worldometers.info

Provisional Death Counts for Coronavirus Disease 2019 (COVID-19)

National Center for Health Statistics

www.cdc.gov

Stats of the States - Influenza/Pneumonia Mortality

www.cdc.gov

 

[SaintJ]

I agree. It's almost a distraction and time-waster to quibble over spacing when the fact is the air is not exchanged, just circulated over and over in that one little room all day long. Add in the A/C which reduces humidity and no or ill-fitting masks and you've got the perfect recipe for transmission.

Edit: And don't forget little humans love to huddle. We need to tell them to stay away from each other without implying their friends are contagious. Think about that.

We need to communicate. But we can't be close and can't project our voices. ???

Exhibit A of why teachers should never be allowed to have any input on education or classroom dynamics...

 

[Saint_Ward]

I tend to think that 3 feet vs. 6 feet doesn't matter much indoors in an enclosed room but only because I think the new evidence is that the virus stays in the air for a long period of time in an unventilated room so 6 feet is almost as bad as 3 feet. Being in an enclosed room that doesn't have some sort of massive ventilation system isn't really a good idea without an N95 or better mask.

I'd love to see a study of an office space with everyone in masks, like a variety of masks, and one person was sick.. either asymptomatic at work, or lightly symptomatic, and then did anyone else get it? How wide spread? Viral swabs, etc.

 

[SaintJ]

I did some more studying of trends late last night, using the Worldometers data, and there are few more things that standout significantly as anomalies.

It is really amazing what can be gleaned once the numbers reach a certain point and trends form, and I can state with a very, very high degree of certainty that these five things are simply not possible:

• Florida has 232,718 cases, but only 4,009 deaths
• Texas has 229,619 cases, but only 2,944 deaths
• Georgia has 103,890 cases, but only 2,922 deaths
• Tennessee has 55,986 cases, but only 685 deaths
• South Carolina has 48,909 cases, but only 884 deaths

Unless most of these states' citizens have different DNA than the rest of the world's, or their populations are remarkably younger (they're not), these numbers are clearly not possible. I am not going to say its intentional, but at a minimal, something is not being tabulated properly.

So, with that in mind, I decided to once again take a look at the Pneumonia and Influenza death data. We have already covered Florida and Texas yesterday, so I will now do Georgia, South Carolina, and Tennessee:

So, once again, either COVID deaths are intentionally being labeled as P&I, or we have an absolutely massive Pneumonia/Influenza pandemic on our hands in specific states but not others.

It doesn't take an Epidemiology degree or being a medical expert to figure these things out. All you have to do is be good at math and simple data analytics.

Here are my sources, in case anyone would like to check my work:

United States COVID - Coronavirus Statistics - Worldometer

United States Coronavirus update with statistics and graphs: total and new cases, deaths per day, mortality and recovery rates, current active cases, recoveries, trends and timeline.

www.worldometers.info

Provisional Death Counts for Coronavirus Disease 2019 (COVID-19)

National Center for Health Statistics

www.cdc.gov

Stats of the States - Influenza/Pneumonia Mortality

www.cdc.gov

Another giant contributor: The number of deaths at home, as was the case in NYC at the height of its particular COVID crisis,

After Deaths At Home Spike In NYC, Officials Plan To Count Many As COVID-19

Officials say a sudden upsurge in deaths at home is likely due to COVID-19 and they are planning to add many of them to New York's death toll, even without confirmation by a laboratory.

www.npr.org

is now skyrocketing in current hot zones:

An increase in people dying at home suggests coronavirus deaths in Houston may be higher than reported

In Houston, one of the nation's fastest-growing coronavirus hot spots, more residents are dying before they can make it to a hospital. Medical examiner data shows that an increasing number of these deaths are the result of COVID-19.

www.texastribune.org

These deaths are not immediately categorized as COVID-based because dead people are at a lower priority for testing than live ones. But if anybody can come up with a plausible reason for these sudden spikes as well, please chime in.

When it comes to fudging data to compromise reality for political purposes, round up the usual suspects. The Venn diagram of these folks and those who rail against "the mainstream media" and "the regulators" and the "scientists" is pretty close to a circle.

 

[St. Widge]

I'd love to see a study of an office space with everyone in masks, like a variety of masks, and one person was sick.. either asymptomatic at work, or lightly symptomatic, and then did anyone else get it? How wide spread? Viral swabs, etc.

I would be great info, but it's likely not going to happen with enough detail about the types of masks and number of people present and for how long. It's just going to have to be a situation where we get lucky to have some of the info since medical ethics doesn't allow us to do these kinds of experiments with controls.