PlagueWatch 2020-23 - Coronavirus

[PackMan97]

Facts about Italy:

• The average age of those who have died was 81.

That was from March 7th when Italy had 233 deaths. I wonder what it is now?

[AustinDevil]

My son and his girlfriend both most likely have COVID 19. They both work in the same office as someone who tested positive and they have the classic COVID19 symptoms. They will never be tested. They will never be counted. They were told by their physicians to stay home and not to go for testing as they were feeling "OK". They were told to contact the medical professionals when they felt worse and only then.

Oh, they will be tested, all right. For antibodies, once we have a reliable antibody test.

Using the stat, the ratio of deaths to recoveries, puts a heavy burden on data collection. For example, "presumed cases" equal positive test results; "serious cases" are measured by hospitalization and its reports to public health authorities; "deaths" are reported to governmental authorities who establish, as best they can, cause of death.

Who collects and measures "recoveries?" What sort of public health measures are there to track those who go home and ride out the illness? I doubt they are required to check in or report status. I suppose there are contacts from the small and heavily burdened public health staffs -- but I doubt they are on top of this.

There is currently no organized tracking whatsoever for recoveries. That will also come later, via antibody testing.

https://www.sciencemag.org/news/2020...virus-pandemic

[Mtn.Devil.91.92.01.10.15]

NC schools closed til 5/15

[Channing]

As a lawyer entering the workforce in 2008, Above the Law was an indispensable source for industry knowledge. It was fun, sardonic, and generally light hearted, but also serve the purpose of allowing young lawyers to get a sense of what was happening at their peer firms and of piercing the perception the big firms tried to maintain. Very sad to see that the founder, David Lat (44), finds himself in critical condition after documenting how hard it was for him to get tested in the first instance.

https://news.yahoo.com/lawyer-live-t...154712928.html

[elvis14]

Facts about Italy:

• More than 99% of Italy’s coronavirus fatalities were people who suffered from previous medical conditions.

I find the statistics that point out previous illnesses are not super useful. How many people over the age of 70 DON'T have some kind of previous medical condition? My parent, aunt's uncles, in-laws, etc are mostly 70-85. All of them have something going on.

I have 2 concerns right now. First is that my Mom, who is in her 70's, a colon cancer survivor and long time smoker is in the bad part of every COVID-19 pie chart ever created. Second is that my wife works at an acute rehab adjacent to a pretty big hospital in Raleigh. If the hospital gets overrun with patients, they may have to use the rehab floors. Not real thrilled with the thought of my wife being on the front line.

[BD80]

Facts about Italy:

• Italy has the oldest population in Europe.
• The average age of those who have died was 81.
• More than 99% of Italy’s coronavirus fatalities were people who suffered from previous medical conditions.
• As of March 14, South Korea reported that nearly 30% of its confirmed coronavirus cases were in patients ages 20 to 29. In Italy, by comparison, 3.7% of coronavirus patients fell into that age range.
• At the outbreak of the crisis, Germany had 29.2 intensive care beds per 100,000 people, whereas Italy had 12.5.

"Facts" belongs in quotes above.

Your "facts" may be greatly distorted by the lack of testing or by selective testing due to shortage.

It has been suggested that the death toll in Italy includes "presumed" death due to coronavirus, and that elderly deaths are presumed to be due to corona virus, as test kits are not wasted on the dead.

Similarly, younger people in Italy are not yet being tested in significant numbers in Italy due to the shortage of test kits and due to the shortage of medical capacity. The South Korea numbers probably reflect a truer measure of who is getting infected.

Until there is widespread testing, few conclusions can be reached other than this is a dangerous situation which deserves to be treated with utmost caution.

[MChambers]

New York Gov. Andrew Cuomo announced Sunday that New York State has acquired 70,000 doses of hydroxychloroquine, 10,000 doses of zithromax and 750,000 doses of chloroquine to implement drug trials to treat patients with coronavirus, which will begin on Tuesday.

Researchers in France recently performed a small study on 30 confirmed COVID-19 patients, treating each with either hydroxychloroquine on its own, a combination of the medicine with the antibiotic, as well as a control group that received neither. Results:

Experts, including Dr. Fauci, have dismissed the French "study" as anedoctal because it was so small and had other obvious flaws. I really don't think it should be touted here.

[Bob Green]

NC schools closed til 5/15

VA schools closed for the remainder of the school year.

Additionally, recreational facilities such as bowling alleys and movie theaters ordered to close.

https://www.wavy.com/news/virginia/c...aths-reported/

[swood1000]

That was from March 7th when Italy had 233 deaths. I wonder what it is now?

According to a USNEWS story published 3/20, the average age of those who died in Italy was 78.5 years, with the youngest victim aged 31 and the oldest 103. The median age was 80. 41% of all those who died were aged between 80-89, with the 70-79 age group accounting for a further 35%.

[AustinDevil]

[M]y Mom, who is in her 70's, a colon cancer survivor and long time smoker is in the bad part of every COVID-19 pie chart ever created.

Being female is correlated with better outcomes, at least, based on what has been reported so far.

[Phredd3]

NC schools closed til 5/15

Yeah, awesome.

Not that I think it's a bad call, mind you.

[swood1000]

[/LIST]

I find the statistics that point out previous illnesses are not super useful. How many people over the age of 70 DON'T have some kind of previous medical condition? My parent, aunt's uncles, in-laws, etc are mostly 70-85. All of them have something going on.

It turns out that the 99% figure relates to an analysis done on 481 of the dead. But that figure relates not just to the elderly who died but to all deaths in Italy. 48.6% of the fatalities had three or more previous pathologies. It simply points to the connection between previous poor health and bad outcomes from Covid-19.

[swood1000]

Being female is correlated with better outcomes, at least, based on what has been reported so far.

According to data from the original outbreak in China, the overall death rate of women is 60% that of men. In an Italy survey, men accounted for 70.6% of the deaths and women 29.4%.

[bedeviled]

Just received this email from the academic medical system that I work with:...[SNIP]...who is best-suited and willing to transition their role to a higher level of care. Their role would elevate to either an intensivist or a hospital-based physician (hospitalist). Training programs are in development for this process."

Hopefully, your employer would provide training sufficient for the need, but who knows? You could enhance your pattern recognition well enough to take care of typical cases and note outliers, which is good enough if the scope of your role is circumscribed and you have support/oversight...like being an intern again. It would be very uncomfortable, though, if they leave you on your own. They apparently judge their model to be worth the risk in care, but do they cover your risk?

NC Dept of Health & Human Services issued a call for volunteers for Clinical (MDs, mid-levels, RNs, EMS), Clinical Support (pharm, imaging, resp care), and Non-Clinical Support (safety, admin) through the NC Training, Exercise, and Response Management System (NC TERMS). They are even issuing emergency licensures to retired and out-of-state MDs. They also added, "Understand that there are many ways to help, including telehealth opportunities, that minimize the risk to clinicians." Furthermore, COVID-19 Medical Response Volunteers in this service will be considered "emergency management workers" and will have certain immunity and liability provisions (link to call for volunteers)

So, if you feel compelled to duty, there may be alternatives to join an effort like this instead of working through your employer's program.

[fisheyes]

According to data from the original outbreak in China, the overall death rate of women is 60% that of men. In an Italy survey, men accounted for 70.6% of the deaths and women 29.4%.

Very interesting fact that women do better. Is it related to the fact that the ACE2 gene is on the X chromosome?

Inappropriate elevation of angiotensin II likely contributes to the development of the severe respiratory distress syndrome seen in COVID19. Recombinant ACE2 or angiotensin-receptor blockade (ARBs) may therefore aid in treatment or prevention of the respiratory problems in COVID19. Animal studies are encouraging and human studies are beginning.

It is way premature to make that recommendation.

The only reason I add this is to say that there may be a reason why women do better.

Time will tell.

[Crisker]

Being female is correlated with better outcomes, at least, based on what has been reported so far.

I have heard this correlation explained as being due primarily to the behavioral fact that males are significantly more likely to be current or ex smokers.

[freshmanjs]

Very interesting fact that women do better. Is it related to the fact that the ACE2 gene is on the X chromosome?

Inappropriate elevation of angiotensin II likely contributes to the development of the severe respiratory distress syndrome seen in COVID19. Recombinant ACE2 or angiotensin-receptor blockade (ARBs) may therefore aid in treatment or prevention of the respiratory problems in COVID19. Animal studies are encouraging and human studies are beginning.

It is way premature to make that recommendation.

The only reason I add this is to say that there may be a reason why women do better.

Time will tell.

Could it have to do with difference in number of smokers and amount of smoking per smoker being different for men vs. women?

[fisheyes]

Could it have to do with difference in number of smokers and amount of smoking per smoker being different for men vs. women?

Anything is possible here.
We are flying blind to some degree.
We will learn so much when this is over.
I just hope we pay attention.

[devildeac]

I have heard this correlation explained as being due primarily to the behavioral fact that males are significantly more likely to be current or ex smokers.

Could it have to do with difference in number of smokers and amount of smoking per smoker being different for men vs. women?

Different/additional article than swood quoted:

https://www.nytimes.com/2020/03/20/h...-men-risk.html


“Being male is as much a risk factor for the coronavirus as being old,” said Sabra Klein, a scientist who studies sex difference in viral infections at Johns Hopkins Bloomberg School of Public Health. “People need to be aware that there is this pattern. Just like being old means you’re at higher risk, so does being male. It’s a risk factor.”



She said the vulnerability could be biological or behavioral. Women have more robust immune systems, Dr. Klein said. And more men smoke in higher numbers, and they are less likely to wash their hands, studies show."

[Mtn.Devil.91.92.01.10.15]

Fired my staff today. With a payout. Hoping they can take advantage of more open unemployment laws. Sucks.