Coronovirus III

[Hatin Since 87]

On a related note I thought was cool... I just got back from a business trip. Normally I wouldnt have traveled except it was critical. In the 3 story Hilton hotel, I was one of 9 guests. Crazy. They have an insane protocol:
They will not enter your room for normal room service. Period. Please place your trash bag(s) outside the room in the hall and they will collect it. If you need anything like more towels, K Cups, etc the front desk will give you some. After you check out, they will not enter your room for 5 days. (to allow the virus to die) they will then thoroughly clean and disinfect the room. Surreal.

After hearing what happens in some hotels, that should be normal protocol.

 

[Alpo]

https://www.theindychannel.com/news...-dies-57-employees-test-positive-for-covid-19

Very stale article. Current stats are, of course, higher deaths of employees and patients.

 

[smokingman]

[FONT=&quot]As of Tuesday night, coronavirus infections had spread in at least 48 U.S. meatpacking plants, sickening more than 2,200 people and killing 17, USA TODAY and the Midwest Center for Investigative Reporting found. The outbreaks also have prompted the closure of at least 17 facilities, including that of the JBS pork plant in Worthington, Minnesota, on Monday. [/FONT]
[FONT=&quot]The Worthington JBS is among the 153 meat processing plants that USA TODAY and the Midwest Center for Investigative Reporting identified as operating in counties with a high rate of coronavirus infection.

While about 2.5 billion pounds of red meat and poultry products are typically warehoused in commercial freezers at any one time as they move along the supply chain, it’s not enough to prevent a shortage, said Don Close, a senior animal protein analyst at Rabo AgriFinance. The freezers typically only hold about one week’s supply of meat, USDA statistics show.

https://www.usatoday.com/in-depth/n...y-force-choice-worker-health-food/2995232001/


[/FONT]

 

[hoosierdoc]

Ok.

Question time. Try not to be defensive

What is the reason for the adamant position of "just like the flu" here? Please dont repeat talking points, I'm actually just wanting to know, politically why some here have the "actually it's not that bad" angle?

If you'd rather PM the reason so as not to give up the game, by all means.

not sure how to answer this. "not that bad" is tricky. it is nowhere near as bad as we were told it was. not because of social distancing, but because the actual number of people who die compared to who get it is WAAY lower than we were told.

there is a very strong push to attack ANY comparison to the flu. I don't understand that. any time I mention influenza I get "this is NOT the FLU" along with a lot of "facts" as to why not.

I used an example of a doc dying after getting the flu from a patient and while tragic it doesn't lead us to go nuts with PPE. the response... "this is not the flu, why do you keep saying it is?" all I did was pick an infectious disease that a patient can give a doc.

it causes worse illness than the flu. I don't know that it's worse than the flu other than we have no immunity. if the antibody studies are correct then the mortality is about the flu rate.

I think comparisons to flu are because every year 40-80k die of the flu and we gave hundreds of thousands of hospital admissions. it actually DOES overwhelm our hospitals. usually our hallways are stuffed with patients and our hospital is on diversion. but we don't do a damn thing different as a society other than recommend a flu shot.

there is some political and moral nirvana about making Corona the worse thing in the universe. and therefore anyone who treats patients is now mother Theresa. and anyone who opposes the lockdown is defeated by a person in scrubs who "spent her day saving lives".

rambling post I know. but in many ways it's the flu
. in some ways it's worse. in some ways it's better. but in all ways our response to it is basically insane.

 

[smokingman]

Though much data is missing or incomplete, the basic numbers are as follows: 9,282 United States health-care workers have been diagnosed with the novel virus through April 2. Of the subset with usable information, 723 were hospitalized, including 184 in the ICU. Twenty-seven have died from Covid-19 infection.
Because this report likely will receive a great deal of scrutiny, the CDC laid out the many limitations of the data. Most limitations would be expected to result in a substantial under reporting of occupationally acquired cases.

https://www.cnn.com/2020/04/15/opinions/health-care-deaths-sepkowitz-opinion/index.html

 

[Alpo]

Though much data is missing or incomplete, the basic numbers are as follows: 9,282 United States health-care workers have been diagnosed with the novel virus through April 2. Of the subset with usable information, 723 were hospitalized, including 184 in the ICU. Twenty-seven have died from Covid-19 infection.
Because this report likely will receive a great deal of scrutiny, the CDC laid out the many limitations of the data. Most limitations would be expected to result in a substantial under reporting of occupationally acquired cases.

https://www.cnn.com/2020/04/15/opinions/health-care-deaths-sepkowitz-opinion/index.html

Depending on how you define and classify "health-care workers", there are almost 17 million healthcare workers in the United States.

So, as a percentage, the numbers you cite are negligible....and I understand that every death is important to someone and since these folks are in harms way, they certainly are important.

But, as data elements, meh.

 

[ghuns]

That is just a biased opinion piece. Anybody that sites that Stanford "study" is not very honest. Plus he is from Stanford so maybe trying to shore up that junk? Also anybody that writes "hospitalization is 0.1 percent per 100,000" is not very scientific.

Fine. Throw out the Stanford stuff. Focus on the New York numbers...

Of all fatal cases in New York state, two-thirds were in patients over 70 years of age; more than 95 percent were over 50 years of age; and about 90 percent of all fatal cases had an underlying illness. Of 6,570 confirmed COVID-19 deaths fully investigated for underlying conditions to date, 6,520, or 99.2 percent, had an underlying illness. If you do not already have an underlying chronic condition, your chances of dying are small, regardless of age. And young adults and children in normal health have almost no risk of any serious illness from COVID-19...

If you're older, if you have an underlying chronic condition you should absolutely take every precaution to avoid catching this bug. Stay home as much as you can, wear a mask and gloves when you're out, etc. But those numbers make it hard to justify continuing to ask us ALL to "shelter in place".

 

[cobber]

Depending on how you define and classify "health-care workers", there are almost 17 million healthcare workers in the United States.

So, as a percentage, the numbers you cite are negligible....and I understand that every death is important to someone and since these folks are in harms way, they certainly are important.

But, as data elements, meh.

As a society we've lost our ability to grasp that people die and how we live is important. Allowing policy to be driven by the desire to 'make us safe' leads to bad policy and governmental overreach. And while a certain group may approve of this today, they will probably be sorry about it tomorrow when it's applied to something they think is important.

 

[smokingman]

Fine. Throw out the Stanford stuff. Focus on the New York numbers...



If you're older, if you have an underlying chronic condition you should absolutely take every precaution to avoid catching this bug. Stay home as much as you can, wear a mask and gloves when you're out, etc. But those numbers make it hard to justify continuing to ask us ALL to "shelter in place".

I see your point of view. I have been seeing it more and more.

Black and white. You will live or die. Most will live. While correct it is horribly simplified and misses so much about this disease. Perfectly healthy athletes even Olympic gold medal swimmers who show permanent damage to their lungs(Cameron van der Burgh of Australia 31 years old) after a "mild" non hospitalized illness.

If you are seeing this as you live or die you are missing most of the real problems this will cause in the future for our health.

No option is without harm. That is the truth. We have no good choices. It is a pandemic.

Open things back up and we have more death and more survivors who will suffer from the damage cause by this for as long as they live.

Stay closed and we add to the destruction already caused by our financial system and current shut down of our economy.

We open even partially and many many more will die. If you do not believe that look back a few posts a few posts and see the 48 meat packing plants that have cases and growing.

It is a pandemic. It is responsible for the chaos. With no stay at home orders we would still be doubling deaths every 2.5 days,now it takes around 10 days for that to happen.

It would be nice if everyone understood what exponential spread was. If they could picture how 15 cases turned into 790,000 in 4 months WITH stay at home orders. What do you think would have happened without them?

Their are no good answers. Their never were as we have never had enough information. So we get this. Chaos being fueled by bias,politics,and fear. It is both sides to. Both sides of the politics and both sides of the keep stay at home orders or open everything back up. Yes we have a little bit of wiggle room in the middle,but not without causing what both sides fear to a lesser degree.

 

[chipbennett]

Yeah, some rooms have that in the hospital ships and in the emergency hospitals they recently put together specifically for the chinese virus outbreak. I wonder how many rooms have that in a typical hospital.

There was one video posted earlier where a general was talking and he said they were able to renovate existing hospital rooms to have negative pressure pretty quickly. That implies that the rooms needed renovation. I suspect many, many average hospital rooms do not have negative pressure capability and I bet this renovation is not cheap. This comes at a time when many hospitals are severely lacking income and may not be able to afford such an expense.

My experience is primarily in drug product manufacturing, not in hospitals; however, the concepts are pretty much the same: use higher differential pressure to keep out things that you don't want in, and use lower pressure to keep bad things in that you don't want getting out. Typically, a facility will have a defined design/plan for air quality zones and room-to-room differential pressure cascades.

I would assume that infectious areas would be treated similarly to (if not the same as) the Biosafety Level (BSL) classifications used in labs and manufacturing, where the most hazardous materials are in the highest-classified spaces, and those spaces have the lowest differential pressure.

Alternately, I would assume that, say, an operating room would follow cleanroom classifications (Grade A-D, ISO classes, etc.), in which the intent is to prevent anything from the ambient air getting inside of patients being operated on. That means very low particulate level in the air, and a differential pressure cascade that goes from higher in the most critical spaces to lower in less-critical spaces.

I would guess that critical areas such as ICUs would have dedicated air handling (HVAC) systems. If true, setting them up as cleanrooms or temporary BSL spaces wouldn't necessarily be all that difficult (think taped, plastic sheet walls for temporary isolation of air flows).

 

[chipbennett]

I've heard pretty much the same sentiment expressed in this forum. So....it wouldn't surprise me that this is a real sign/protester.

[Citation Needed]

I've seen that presented as a straw man, and as an inference from some arguments that have been made. I have not seen anyone articulate a sincere "sacrifice the weak" argument.

 

[smokingman]

Those small business loans did not end up going to small business.

U.S. government has allocated at least $243.4 million of the total $349 billion to publicly traded companies
[FONT=&quot]Several of the companies have market values well in excess of $100 million, including DMC Global, Wave Life Sciences and Fiesta Restaurant Group.
[/FONT]https://www.cnbc.com/2020/04/21/lar...re-taking-small-businesses-payroll-loans.html

 

[chipbennett]

Ok.

Question time. Try not to be defensive

What is the reason for the adamant position of "just like the flu" here? Please dont repeat talking points, I'm actually just wanting to know, politically why some here have the "actually it's not that bad" angle?

If you'd rather PM the reason so as not to give up the game, by all means.

I think, when all data are in, COVID-19 will prove to be essentially like influenza in terms of overall spread and mortality.

That said - and as I have always maintained - COVID-19 is very much unlike influenza in terms of severity and targets/at-risk demographics.

I believe those two points get conflated all too easily.

 

[chipbennett]

On a related note I thought was cool... I just got back from a business trip. Normally I wouldnt have traveled except it was critical. In the 3 story Hilton hotel, I was one of 9 guests. Crazy. They have an insane protocol:
They will not enter your room for normal room service. Period. Please place your trash bag(s) outside the room in the hall and they will collect it. If you need anything like more towels, K Cups, etc the front desk will give you some. After you check out, they will not enter your room for 5 days. (to allow the virus to die) they will then thoroughly clean and disinfect the room. Surreal.

Standard right now, it seems. I coordinated lodging for a team of 20+ people at a hotel here outside of Cleveland. I arranged for our project team to have a dedicated floor in the hotel, for (two-way) sequestering. All amenities are front-desk pick-up on-demand. They are setting up a schedule to clean everyone's rooms and restock once a week (this is a 10-12 week-long project).

 

[chipbennett]

[FONT=&amp]As of Tuesday night, coronavirus infections had spread in at least 48 U.S. meatpacking plants, sickening more than 2,200 people and killing 17, USA TODAY and the Midwest Center for Investigative Reporting found. The outbreaks also have prompted the closure of at least 17 facilities, including that of the JBS pork plant in Worthington, Minnesota, on Monday. [/FONT]
[FONT=&amp]The Worthington JBS is among the 153 meat processing plants that USA TODAY and the Midwest Center for Investigative Reporting identified as operating in counties with a high rate of coronavirus infection.

While about 2.5 billion pounds of red meat and poultry products are typically warehoused in commercial freezers at any one time as they move along the supply chain, it’s not enough to prevent a shortage, said Don Close, a senior animal protein analyst at Rabo AgriFinance. The freezers typically only hold about one week’s supply of meat, USDA statistics show.

https://www.usatoday.com/in-depth/n...y-force-choice-worker-health-food/2995232001/


[/FONT]

The spread of COVID-19 in meat-packing plants is interesting. Coincidentally, it was the inexcusably poor working conditions in meat-packing plants that ultimately led to FDA regulation of the food and pharmaceutical industries and implementation of Good Manufacturing Practices. (See "The Jungle" by Upton Sinclair, which led to sufficient public outcry that Congress passed the 1906 "Wiley" Food and Drugs Act under which FDA was founded - and follow-on legislation including the 1938 Food, Drugs, and Cosmetic Act, the FD&C Act or "the Act".)

 

[smokingman]

[FONT=&amp]

Largest US case study so far.[/FONT][FONT=&amp]A total of 5700 patients were included median age, 63 years all in New York.[/FONT][FONT=&amp]
[/FONT]https://jamanetwork.com/journals/jama/fullarticle/2765184


Some interesting things.

This was something we where debating yesterday that I picked up though.

[FONT=&amp]A total of 45 patients (2.2%) were readmitted during the study period.


[/FONT][FONT=&amp]Among the 2634 patients who were discharged or had died at the study end point, during hospitalization, 373 (14.2%) were treated in the ICU, 320 (12.2%) received invasive mechanical ventilation, 81 (3.2%) were treated with kidney replacement therapy, and 553 (21%) died


[/FONT][FONT=&amp]Of the patients who died, those with diabetes were more likely to have received invasive mechanical ventilation or care in the ICU compared with those who did not have diabetes (eTable 1 in the [/FONT]Supplement[FONT=&amp]). Of the patients who died, those with hypertension were less likely to have received invasive mechanical ventilation or care in the ICU compared with those without hypertension. The percentage of patients who developed acute kidney injury was increased in the subgroups with diabetes compared with subgroups without those conditions.


[/FONT]

 

[jsharmon7]

But seriously, when the morning/afternoon crew wakes up, I do want some help with this. It's something I've asked a few other places than just INGO, not getting great answers. Again, I want the meta-level explanation. The "no evidence reeeeeeee" thing isnt really what I'm looking for.

You aren’t getting responses because the question you’re asking is sort of a straw man (maybe not the best term). I haven’t seen hardly anyone, lately, saying it’s just the flu. A lot of people are very upset about the handling of the situation and the lockdowns, but not too many people still think it’s no worse than the flu. It doesn’t seem to hit a very large number of our population hard, but it’s definitely very bad for those at-risk.

My issue with it is much like HoosierDoc stated. There was this Doomsday push from the beginning and the numbers just aren’t bearing that out. Maybe it’s because of the measures that were put in place, or maybe because the models were flawed. Either way, we’ve “flattened the curve” and it doesn’t seem like there’s a solid plan now.

I also can’t stand how it’s become moral high ground for people to pat themselves on the back. Calling the police on people and brow-beating everyone about staying home is obnoxious. Some people haven’t lost their jobs and aren’t worried about feeding their family, but they’ll quickly condemn those desperate to return to work.

I hope we’ve learned a lesson from trying to use models to predict the future. It hasn’t worked and may very well turn out to have caused more harm than good.

 

[Phase2]

Those small business loans did not end up going to small business.

U.S. government has allocated at least $243.4 million of the total $349 billion to publicly traded companies
[FONT="]Several of the companies have market values well in excess of $100 million, including DMC Global, Wave Life Sciences and Fiesta Restaurant Group.
[/FONT]https://www.cnbc.com/2020/04/21/lar...re-taking-small-businesses-payroll-loans.html

Huh? The article is talking about the < 0.1% that went to publicly traded companies. That's obviously not good, but it was stated up front that they were aiming to act quickly and not perfectly to help small businesses ASAP. The government acting as quickly as they did is a minor miracle, but it isn't shocking that there is some cleanup needed after the fact.

 

[chipbennett]

[FONT=&amp]Of the patients who died, those with diabetes were more likely to have received invasive mechanical ventilation or care in the ICU compared with those who did not have diabetes (eTable 1 in the [/FONT]Supplement[FONT=&amp]). Of the patients who died, those with hypertension were less likely to have received invasive mechanical ventilation or care in the ICU compared with those without hypertension. The percentage of patients who developed acute kidney injury was increased in the subgroups with diabetes compared with subgroups without those conditions.
[/FONT]

Is this outcome related to the hACE/ACE2 connection with COVID-19?

 

[Alpo]

Reviewing the article that smokingman cited, https://jamanetwork.com/journals/jama/fullarticle/2765184#note-JOI200043-1, the charts are pretty interesting. What isn't really "in the public eye" very much is the possible severe kidney damage that may result if a person catches a severe case of the virus. Diabetics really need to be careful here.