OT: Coronavirus 2 - Covid Boogaloo

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jiitu

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Jun 17, 2013
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Damn, corona chains seem to get locked one after another soon after I have posted those. Among others the first corona thread in main page got locked soon after I forecasted there that in one month, world will look very different and NHL season will most likely be cancelled. I guess in that point such comments were not acceptable. Now I just posted something here adn new thread was opened. This time at least it's not anyway me ;) Anyway I bit break the rules and copy my message here.

I have anyway followed the case since mide feruary with close eyes and made also some simple simulations on spreading.




Goldman Sachs has estimated GDP for Q2 will be down 24%.

Such is the price of business to save lives at this point. Unfortunately people still aren't understanding this.

Why We Are Deliberately Allowing Our Economy To Go On A Downward Spiral


The problem here is..no much lives are saved anyways without huge impact. I mean even bigger. You can't control the virus so that the hospital capacity is more or less enough but that virus reaches enough people.

By "enough" I mean, to get group immunity. As very early precautions were not made no where around the world, the options are:
1a) complete shut down for couple of months to stop epidemic now. But the problem is what happens after stopping restrictions. You have then new chance to try control all chains of infections and hope it won't spread again and then with good possibility is that the vaccine is ready until the late summer/autumn and after vaccination of many people, this is over.
1b) control of chains is not working well enough after complete shutting down and full closure need to e done again at latest in autumn. Even worse, vaccine is ready in 1-2 years and shutting down world needs to be made again and again. Or let it spread then.

2) Just let it spread now, try to keep risk groups as isoleted as possible for few months. Victims will come yes. But with current estimate of infection factor R0 = 2,2 without restrictions and 5 day average latency phase, some about 30 % (might require up to 40-45 %) of infected people might be enough to get group immunity. It bit depends on social networks (how much variation there is how people meet each others). In this case, the total R0 drops below 1, meaning one infected person infects on average less than 1 new person causing that all chains die themselves. This takes several months and is horrible time but after that, it's kind of all over once and for real.

What is the right play, depends strongly on how effective medications will be available nearest weeks and when the vaccine will be ready. But as big financial depression causes also lot of victims and much more young such, it is not possible at all that the tactic with (almost) free spreading will be actually the winning tactic now. It all can be seen and judged only in the future.

Right now we might have some first signes of new spreading in China after ending the strongest controls. There were few days jus tnow in weekend without any local infections so all cases were comng from abroad. Now the number of cases per day doubled from normla level of past weeks. Myabe just coincidence, but it is pretty likely that after returning normal life, this all starts in China again until group immuity/vaccine is reached.
 
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The Faulker 27

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SlavinAway

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Damn, corona chains seem to get locked one after another soon after I have posted those. Among others the first corona thread in main page got locked soon after I forecasted there that in one month, world will look very different and NHL season will most likely be cancelled. I guess in that point such comments were not acceptable. Now I just posted something here adn new thread was opened. This time at least it's not anyway me ;) Anyway I bit break the rules and copy my message here.

I have anyway followed the case since mide feruary with close eyes and made also some simple simulations on spreading.




Goldman Sachs has estimated GDP for Q2 will be down 24%.

Such is the price of business to save lives at this point. Unfortunately people still aren't understanding this.

Why We Are Deliberately Allowing Our Economy To Go On A Downward Spiral


The problem here is..no much lives are saved anyways without huge impact. I mean even bigger. You can't control the virus so that the hospital capacity is more or less enough but that virus reaches enough people.

By "enough" I mean, to get group immunity. As very early precautions were not made no where around the world, the options are:
1a) complete shut down for couple of months to stop epidemic now. But the problem is what happens after stopping restrictions. You have then new chance to try control all chains of infections and hope it won't spread again and then with good possibility is that the vaccine is ready until the late summer/autumn and after vaccination of many people, this is over.
1b) control of chains is not working well enough after complete shutting down and full closure need to e done again at latest in autumn. Even worse, vaccine is ready in 1-2 years and shutting down world needs to be made again and again. Or let it spread then.

2) Just let it spread now, try to keep risk groups as isoleted as possible for few months. Victims will come yes. But with current estimate of infection factor R0 = 2,2 without restrictions and 5 day average latency phase, some about 30 % (might require up to 40-45 %) of infected people might be enough to get group immunity. It bit depends on social networks (how much variation there is how people meet each others). In this case, the total R0 drops below 1, meaning one infected person infects on average less than 1 new person causing that all chains die themselves. This takes several months and is horrible time but after that, it's kind of all over once and for real.

What is the right play, depends strongly on how effective medications will be available nearest weeks and when the vaccine will be ready. But as big financial depression causes also lot of victims and much more young such, it is not possible at all that the tactic with (almost) free spreading will be actually the winning tactic now. It all can be seen and judged only in the future.

Right now we might have some first signes of new spreading in China after ending the strongest controls. There were few days jus tnow in weekend without any local infections so all cases were comng from abroad. Now the number of cases per day doubled from normla level of past weeks. Myabe just coincidence, but it is pretty likely that after returning normal life, this all starts in China again until group immuity/vaccine is reached.

You can save many lives though by spreading out the infections over time and not hitting hospitals with a huge bolus of cases. Also, this gives time for more treatment options and eventually a vaccine to become available.

Yes, there will be severe economic consequences and I don't want to downplay those because I know there are many, many people hurting right now because of it. But when hospitals become overwhelmed it's not just extra COVID patients who will die; the mortality rates of every illness and injury requiring care will also increase because they will be competing for the same limited resources. Listen to the doctors on the frontlines in Italy and Spain who are trying to warn us.

You can rebuild an economy; you can't rewind and save more lives.
 

Boom Boom Apathy

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Talked to a colleague in China today, he’s in Shanghai which is ~500mi/800km from Wuhan. He said things are pretty much back to normal now, in terms of restrictions, businesses opening, etc.
 

jiitu

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Jun 17, 2013
274
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You can save many lives though by spreading out the infections over time and not hitting hospitals with a huge bolus of cases. Also, this gives time for more treatment options and eventually a vaccine to become available.

You can rebuild an economy; you can't rewind and save more lives.

I fully understand this and agree with the last sentence. The problem in the first just comes cis that if total shut down is not made and 20+ % of infection rate is coming, it will be such a high peak that spreading does not have pretty limited effect after the obvious limitations. I let the numbers speak: For example simulation (disclaimer, only my own, not official but giving the right direction) in Finland and taking into account the numbers here (number of intensive care places etc.), letting it spread without restrictions, so

R0 = 2,2 gives about 55 % infection rate, 99 % of cases during the highest peak and ony about 10 % of patients would get the intensive care who would need.

Wiht current obvious limitations here (schools mainly closed, all bigger meetings cancelled etc.) it is asteomated that (by autority) R0 = 1,42. With this, we get numbers 33 % infection rate, 95 % during the highest peak (bit longer giving more time for taking care) and about 25 % in need will get intensive care.

So these pretty strickt restrictions already limit the numbers yes, but the biggset problem is that to get these numbers, you have to keep limitations for long. Keeping them now for 6 months and then stopping the, will increase the total victims to 2,2 million, so need to keeo them 7-8 months.

And very intensive limitations to dropping to R0 = 1,2 for few months will limit the initial infected people tobit under 20 % but then, theres no group immunity and hte seonc wave will cause a need for new big limitations.
 
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Navin R Slavin

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I fully understand this and agree with the last sentence. The problem in the first just comes cis that if total shut down is not made and 20+ % of infection rate is coming, it will be such a high peak that spreading does not have pretty limited effect after the obvious limitations. I let the numbers speak: For example simulation (disclaimer, only my own, not official but giving the right direction) in Finland and taking into account the numbers here (number of intensive care places etc.), letting it spread without restrictions, so

R0 = 2,2 gives about 55 % infection rate, 99 % of cases during the highest peak and ony about 10 % of patients would get the intensive care who would need.

Wiht current obvious limitations here (schools mainly closed, all bigger meetings cancelled etc.) it is asteomated that (by autority) R0 = 1,42. With this, we get numbers 33 % infection rate, 95 % during the highest peak (bit longer giving more time for taking care) and about 25 % in need will get intensive care.

So these pretty strickt restrictions already limit the numbers yes, but the biggset problem is that to get these numbers, you have to keep limitations for long. Keeping them now for 6 months and then stopping the, will increase the total victims to 2,2 million, so need to keeo them 7-8 months.

And very intensive limitations to dropping to R0 = 1,2 for few months will limit the initial infected people tobit under 20 % but then, theres no group immunity and hte seonc wave will cause a need for new big limitations.

Now compare these numbers to what China and South Korea have done. What's the difference? Why is China now able to open up?
 
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MrazeksVengeance

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So my biggest achievements at my ward today were switching search engines on doctors' PCs from Bing to Google and making an Excel table for MULBSTA score (evaluation of risk factors in viral pneumonia). People in healthcare are notoriously bad with computers outside of the primary programs they use every day.

My doctors are getting used to using me for additional tasks.

I am almost settled in and shopped at my lodgings and I should get some respirators today.

Given circumstances... today's been a good workday.
 

Unsustainable

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DaveG

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So my biggest achievements at my ward today were switching search engines on doctors' PCs from Bing to Google and making an Excel table for MULBSTA score (evaluation of risk factors in viral pneumonia). People in healthcare are notoriously bad with computers outside of the primary programs they use every day.

My doctors are getting used to using me for additional tasks.

I am almost settled in and shopped at my lodgings and I should get some respirators today.

Given circumstances... today's been a good workday.

Holy shit you're not kidding here. There's a reason that at every hospital I've ever worked for the attendings that are in contact with me love me. I know what I'm doing (at least in tech), I can get it done fast and correctly, and I put up with minimal bullshit.

Also being the guy that has admin credentials when they just need to get Chrome on to their computers because Edge should have been outlawed by the Geneva Convention helps.
 

MinJaBen

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Holy shit you're not kidding here. There's a reason that at every hospital I've ever worked for the attendings that are in contact with me love me. I know what I'm doing (at least in tech), I can get it done fast and correctly, and I put up with minimal bullshit.

Also being the guy that has admin credentials when they just need to get Chrome on to their computers because Edge should have been outlawed by the Geneva Convention helps.

My wife wishes you worked for the VA right about now...
 
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Holy shit you're not kidding here. There's a reason that at every hospital I've ever worked for the attendings that are in contact with me love me. I know what I'm doing (at least in tech), I can get it done fast and correctly, and I put up with minimal bullshit.

Also being the guy that has admin credentials when they just need to get Chrome on to their computers because Edge should have been outlawed by the Geneva Convention helps.

I get to choose between Edge and IE on my work computer. :cry:
 
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SlavinAway

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My wife and one of her coworkers received notice from their OBs today that per new guidance any pregnant healthcare workers in their 3rd trimester (28+ weeks) should be removed from direct patient care.

Will be interesting to see what happens.
 

MinJaBen

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Chloroquine (and Hydroxychloroquine) is being used across the countries by DOCTORS to treat/prevent this virus.

Again, DO NOT DRINK fish tank cleaner, one is a medication, one is a cleaner that will kill you.
Is Chloroquine a Cure for Coronavirus? Scientists Say Maybe | Heavy.com

Elon Musk and some doctors was going about this:



I thought that might be the drug you were referring to with your original post. There are some ongoing studies to look at the efficacy of using it offlable to treat the COVID-19. One of the earliest got a lot of peoples hopes up, but it was very small and had some significant flaws. It came out of Europe and showed in a group of twenty patients that there was a substantial reduction in the number of virus particles in the nose after 6 days of the patients taking the drug compared to the control group. But they only followed for six days. And over those six days, the mortality rate was 4%...which is actually a little higher than what is seen in most of the world. Larger numbers of treated patients will be needed to see if this actually was an anomaly, only affects viral shedding and not the mortality of the patients, or is truly a good treatment going forward.
 
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