PlagueWatch 2020-23 - Coronavirus

[devildeac]

I was posting the COVID-19 updates almost daily and haven't in a while. There has been very little change over the past nine days. The seven-day average for new cases has dropped from 43,300 to 42,500 -- less than two percent (per Worldometers). The seven-day average of new deaths has dropped from 971 to 934 -- less than four percent.

This is really dismaying. I suppose returning to school will naturally spur contact and lead to new case, offsetting a more secular decline as Arizona, Florida, Texas. Louisiana, Alabama, Georgia, South Carolina and other states move past their peaks.

Imagine what we'll see after Labor Day weekend...

[sagegrouse]

Article features Duke and contrasts Duke with State and UNC. "Mass testing" has been the key.

By the way, we are losing 46-800 and 46-900, respectively. Duke figures include students, faculty and staff.

Money quote:

“We don’t have large, unsupervised fraternity and sorority houses,” he said. “It’s not part of our culture. ... It’s clearly been a challenge and problem for other universities around the country.”

There’s also a bit of luck and serendipity, [PA VP Mike] Schoenfeld said.

“All of this could change quickly,” he said. “Our feeling has been very much like a tournament: survive and advance. And that’s what we’re going to keep doing.”

[Bluedog]

Thought this was an interesting piece...
https://www.wsj.com/articles/covid-l...uG1Q4l1v3xCjBM

Dr. Mina of Harvard said the U.S. at the outset could have chosen to prioritize the economy, as Sweden did, and accept the deaths, or it could have chosen to fully prioritize health by staying locked down until new infections were so low that testing and tracing could control new outbreaks, as some northeastern states such as Rhode Island did.

Most of the U.S. did neither. The result was “a complete disaster. We’re harming the economy, waffling back and forth between what is right, what is wrong with a slow drift of companies closing their doors for good,” Dr. Mina said.

The U.S. never resolved “whether we were going for mitigation or suppression,” said Paul Romer, a Nobel laureate economist. Mitigation, he said, meant accepting hundreds of thousands of additional deaths to achieve herd immunity, which no leaders were willing to embrace. But total suppression of the disease “doesn’t make sense unless you’re going to stick with it as long as it takes."

Basically, argues that taking the middle ground and having a patchwork of policies was basically the worst possible approach. Also argues that many Asian counties have been able to control things WITHOUT full lockdowns with just a consistent change of behavior (distancing, mask-wearing) by its citizenry.

Taiwan, South Korea and Hong Kong set early examples of how to stop Covid-19 without lockdowns. Their reflexes trained by SARS in 2003, MERS and avian flu, they quickly cut travel to China, introduced widespread testing to isolate the infected and traced contacts. Their populations quickly donned face masks.

[YmoBeThere]

I was posting the COVID-19 updates almost daily and haven't in a while. There has been very little change over the past nine days. The seven-day average for new cases has dropped from 43,300 to 42,500 -- less than two percent (per Worldometers). The seven-day average of new deaths has dropped from 971 to 934 -- less than four percent.

This is really dismaying. I suppose returning to school will naturally spur contact and lead to new case, offsetting a more secular decline as Arizona, Florida, Texas. Louisiana, Alabama, Georgia, South Carolina and other states move past their peaks.

A lot of this can be attributed to states like MI, OH, and VA maintaining consistent numbers of cases daily. They haven't seen the big spikes(for those states something like 4-5k) but have had consitent numbers every day for the last 6-7 weeks.

[Phredd3]

A lot of this can be attributed to states like MI, OH, and VA maintaining consistent numbers of cases daily. They haven't seen the big spikes(for those states something like 4-5k) but have had consitent numbers every day for the last 6-7 weeks.

I think North Carolina pretty much fits that description, as well. We've been averaging +- 1,500 new cases daily since roughly late June. We had a bit of a peak in July, coming down a bit by the start of August, but holding quite steady since then. Fortunately, hospitalizations have been down. Less fortunately, testing in the last week has down, although that may be an artifact. Testing always goes way down on weekends, so it is possible reporting for the last several days has just not caught up with reality.

[curtis325]

The New York times reports the first COVID death of a Sturgis event goer. Many more are ill and spreading the disease.

https://www.nytimes.com/2020/09/02/w...ronavirus.html

[Jeffrey]

The New York times reports the first COVID death of a Sturgis event goer. Many more are ill and spreading the disease.

https://www.nytimes.com/2020/09/02/w...ronavirus.html

IIRC, that event attracts many seniors. IMO, many unnecessary deaths are almost certain.

I’m not attending any annual events this year, in hopes I stay alive and can attend those events for the next 25 years.

[JasonEvans]

I was posting the COVID-19 updates almost daily and haven't in a while. There has been very little change over the past nine days. The seven-day average for new cases has dropped from 43,300 to 42,500 -- less than two percent (per Worldometers). The seven-day average of new deaths has dropped from 971 to 934 -- less than four percent.

This is really dismaying. I suppose returning to school will naturally spur contact and lead to new case, offsetting a more secular decline as Arizona, Florida, Texas. Louisiana, Alabama, Georgia, South Carolina and other states move past their peaks.

I will say one hopeful thing. If the current new case rate is staying in the 40k kind of range due to spread on campuses, then perhaps we will see the death rate begin to decline because we know this disease is far less deadly among young people than when it runs through the rest of the population.

If this proves to be true, we should start to see a drop in the death numbers in a week or two.

[budwom]

Vermont is running out of tests, despite having a tiny population...not an encouraging thing, what with students back at colleges and high schools, businesses expanding operations. Ack. Should not be this way, fully six months after the crisis began.

[duke79]

Very interesting (and scary) story on recent research on Covid-19, using a super computer to analyze the available data:

https://elemental.medium.com/a-super...d-31cb8eba9d63

[freshmanjs]

Very interesting (and scary) story on recent research on Covid-19, using a super computer to analyze the available data:

https://elemental.medium.com/a-super...d-31cb8eba9d63

Why is it scary? If it’s correct, it is great news, opening clear treatment options to explore.

[OldPhiKap]

Why is it scary? If it’s correct, it is great news, opening clear treatment options to explore.

[whisper] except you're teaching the computers how to kill us. [/whisper]

[dukebluesincebirth]

I think North Carolina pretty much fits that description, as well. We've been averaging +- 1,500 new cases daily since roughly late June. We had a bit of a peak in July, coming down a bit by the start of August, but holding quite steady since then. Fortunately, hospitalizations have been down. Less fortunately, testing in the last week has down, although that may be an artifact. Testing always goes way down on weekends, so it is possible reporting for the last several days has just not caught up with reality.

Yep. Right on pace with a report of 1,656 today in NC. So what do the experts project for these states in the "holding steady" pattern? 1,500 per day sounds like a lot of cases to me, but I'm surely not an expert and maybe this isn't an important metric? I assume that at this point, those who have decided that social distancing and mask wearing are important are consistently doing those things, and those who never believed in it aren't going to start. So here we are. Now where do we go? Is this still part of the "first wave?" Are waves even a thing anymore? Are we looking at ~ 1,500 a day until a vaccine arrives? If an effective vaccine took another 6 months to implement, that's about another 250,000 cases in NC. We're already 9th in the nation in total cases since March at 170, 570 (according to NCDHHS website data).

[sagegrouse]

Yep. Right on pace with a report of 1,656 today in NC. So what do the experts project for these states in the "holding steady" pattern? 1,500 per day sounds like a lot of cases to me, but I'm surely not an expert and maybe this isn't an important metric? I assume that at this point, those who have decided that social distancing and mask wearing are important are consistently doing those things, and those who never believed in it aren't going to start. So here we are. Now where do we go? Is this still part of the "first wave?" Are waves even a thing anymore? Are we looking at ~ 1,500 a day until a vaccine arrives? If an effective vaccine took another 6 months to implement, that's about another 250,000 cases in NC. We're already 9th in the nation in total cases since March at 170, 570 (according to NCDHHS website data).

Seven-day moving average peaked at 2,011 cases on July 18, dipped to around 1,200 a month later and is now at 1,650 two+ weeks later. So, there has been a recent increase in cases.

While NC is ninth in total cases, it is a relatively large state. It is 25th in cases per one million population. NC is well below most of the other states in the South -- the exception being Virginia. NC has 16,364 cases per million through yesterday. LA is twice that and most of the other Southern states, including Texas, are between 22,000 and 30,000 cases per million.

[YmoBeThere]

I think North Carolina pretty much fits that description, as well. We've been averaging +- 1,500 new cases daily since roughly late June. We had a bit of a peak in July, coming down a bit by the start of August, but holding quite steady since then. Fortunately, hospitalizations have been down. Less fortunately, testing in the last week has down, although that may be an artifact. Testing always goes way down on weekends, so it is possible reporting for the last several days has just not caught up with reality.

Yep. Right on pace with a report of 1,656 today in NC. So what do the experts project for these states in the "holding steady" pattern? 1,500 per day sounds like a lot of cases to me, but I'm surely not an expert and maybe this isn't an important metric? I assume that at this point, those who have decided that social distancing and mask wearing are important are consistently doing those things, and those who never believed in it aren't going to start. So here we are. Now where do we go? Is this still part of the "first wave?" Are waves even a thing anymore? Are we looking at ~ 1,500 a day until a vaccine arrives? If an effective vaccine took another 6 months to implement, that's about another 250,000 cases in NC. We're already 9th in the nation in total cases since March at 170, 570 (according to NCDHHS website data).

Seven-day moving average peaked at 2,011 cases on July 18, dipped to around 1,200 a month later and is now at 1,650 two+ weeks later. So, there has been a recent increase in cases.

While NC is ninth in total cases, it is a relatively large state. It is 25th in cases per one million population. NC is well below most of the other states in the South -- the exception being Virginia. NC has 16,364 cases per million through yesterday. LA is twice that and most of the other Southern states, including Texas, are between 22,000 and 30,000 cases per million.

The reason I made note of these states is that the virus is prevalent enough to not go away any time soon, but there hasn't been a big enough spike to frighten people in to really adjusting their behavior. I think that portends a slow but consistent burn that dukebluesincebirth mentions. One that doesn't overwhelm the healthcare system but is an ever present issue until a vaccine arrives.

[rsvman]

Very interesting (and scary) story on recent research on Covid-19, using a super computer to analyze the available data:

https://elemental.medium.com/a-super...d-31cb8eba9d63

This is a really great link, and a fascinating theory that actually makes a lot of sense. I'm no expert in the RAS or in bradykinin and/or bradykinin storm, but it seems to be a viable hypothesis. In addition to the drugs mentioned in the article, there are also other compounds isolated from plants that are strong blockers of bradykinin that may or may not be useful for severe Covid-19.

I don't know if I have mentioned this here before (I well may have), but one of my friends and colleagues just left my practice to test and market a new drug temporarily called "PIC-1" (peptide inhibitor of complement) that will be enrolling severe Covid-19 patients in a trial really soon, probably sometime this month. The complement system is involved in cytokine storm, and, as it turns out, is also involved in bradykinin storm, so the drug may help regardless of whether the problem is really mostly bradykinin storm or mostly cytokine storm, or perhaps a combination of the two. PIC-1 has a mechanism of action unlike that of any other drug ever developed, and it inhibits complement as potently as any substance known to mankind. I hope this thing puts the strong brakes on both kinds of "storm" and saves a lot of lives.

I am also sure that there will fairly soon be trials of specific bradykinin pathway inhibitors. It will be interesting to see how it plays out.

[sparv]

This is a really great link, and a fascinating theory that actually makes a lot of sense. I'm no expert in the RAS or in bradykinin and/or bradykinin storm, but it seems to be a viable hypothesis. In addition to the drugs mentioned in the article, there are also other compounds isolated from plants that are strong blockers of bradykinin that may or may not be useful for severe Covid-19.

I don't know if I have mentioned this here before (I well may have), but one of my friends and colleagues just left my practice to test and market a new drug temporarily called "PIC-1" (peptide inhibitor of complement) that will be enrolling severe Covid-19 patients in a trial really soon, probably sometime this month. The complement system is involved in cytokine storm, and, as it turns out, is also involved in bradykinin storm, so the drug may help regardless of whether the problem is really mostly bradykinin storm or mostly cytokine storm, or perhaps a combination of the two. PIC-1 has a mechanism of action unlike that of any other drug ever developed, and it inhibits complement as potently as any substance known to mankind. I hope this thing puts the strong brakes on both kinds of "storm" and saves a lot of lives.

I am also sure that there will fairly soon be trials of specific bradykinin pathway inhibitors. It will be interesting to see how it plays out.

Wishing your friends and colleagues the best of luck!

The bradykinin thing is interesting. I am not a doctor or scientist, but I wonder if some of the bad results among those with high blood pressure might also (but not solely) because of people taking an ACE inhibitor. The ACE inhibitor already prevents you from getting rid of bradykinins, so when hit with COVID, someone would have bradykinins upon bradykinins (which sounds vaguely like something from Brigadoon or a Tom Brady fan club). Regardless, it is interesting to see the efforts being made to understand the disease.

[MChambers]

Wishing your friends and colleagues the best of luck!

The bradykinin thing is interesting. I am not a doctor or scientist, but I wonder if some of the bad results among those with high blood pressure might also (but not solely) because of people taking an ACE inhibitor. The ACE inhibitor already prevents you from getting rid of bradykinins, so when hit with COVID, someone would have bradykinins upon bradykinins (which sounds vaguely like something from Brigadoon or a Tom Brady fan club). Regardless, it is interesting to see the efforts being made to understand the disease.

Not to get technical, but I think that condition is known as the Brady Bunch.

[Duke79UNLV77]

D0E4DF30-A8BB-4349-B787-93589A6558B4.jpg

Whoever lives here must be really fun.

"Private Property. No Trespassing. No Public Health Entry. Public Health Officials Stay Out. Mask Patrol Prohibited. Protestors. No Soliciting. No Loitering." And then quotes the state statute on criminal trespass.

[PackMan97]

This is a really great link, and a fascinating theory that actually makes a lot of sense. I'm no expert in the RAS or in bradykinin and/or bradykinin storm, but it seems to be a viable hypothesis. In addition to the drugs mentioned in the article, there are also other compounds isolated from plants that are strong blockers of bradykinin that may or may not be useful for severe Covid-19.

I don't know if I have mentioned this here before (I well may have), but one of my friends and colleagues just left my practice to test and market a new drug temporarily called "PIC-1" (peptide inhibitor of complement) that will be enrolling severe Covid-19 patients in a trial really soon, probably sometime this month. The complement system is involved in cytokine storm, and, as it turns out, is also involved in bradykinin storm, so the drug may help regardless of whether the problem is really mostly bradykinin storm or mostly cytokine storm, or perhaps a combination of the two. PIC-1 has a mechanism of action unlike that of any other drug ever developed, and it inhibits complement as potently as any substance known to mankind. I hope this thing puts the strong brakes on both kinds of "storm" and saves a lot of lives.

I am also sure that there will fairly soon be trials of specific bradykinin pathway inhibitors. It will be interesting to see how it plays out.

If there is a silver lining to all this mess, I feel like a global crisis like this is really pushing forward our understanding of the body and how it works. This is some interesting stuff even if it all flies over my head.